Ohio Beer And Malt Beverage Tax Return {ALC 83}

ALC 83 Rev. 5/15 P.O. Box 530 Columbus, OH 43216-0530 Ohio Beer and Malt Beverage Tax Return Return is due on or before the 10th day of the month following the reporting period. Reporting period For Department of Taxation Use Only 20 FEIN Account number Name Address City State ZIP 1. Schedule A line 3 2. Schedules B and B1 line 4 3. Total beer and malt beverage tax liability (total of lines 1 and 2) 4. Monthly advance tax payment received by the Ohio Department of Taxation on or before 18th day of report period 5. If line 3 exceeds line 4, enter difference here 6. If line 3 exceeds line 4, enter line 4 multiplied by 10% $ $ $ $ $ $ $ $ $ 7. Discount (enter the lesser of line 5 or 6 multiplied by 3%) 8. If line 4 exceeds line 3, enter difference here 9. Monthly advance tax payment received by the Ohio Department of Taxation between the 19th and the last day of the report period 10. Credit balance, if any, from previous return 11. Additional credit (line 4 multiplied by 3%) 12. Total of lines 7, 8, 9, 10 and 11 13. Tax due, if any (if line 5 exceeds line 12, enter difference here or line 3 if no advance payment was made) 14. Credit balance, if any (if line 12 exceeds line 5, enter difference here and carry forward to line 10 of next return) I declare under penalties of perjury that this return, including any accompanying schedules and statements, has been examined by me and, to the best of my knowledge and belief is a true, correct and complete return and report. $ $ $ $ $ Complete lines 4 through 12 only if you made an advance payment. Authorized signature Telephone Date Make check or money order payable to the Ohio Treasurer of State and mail to Ohio Department of Taxation, P.O. Box 530, Columbus, OH 43216-0530. This tax return and payment must be postmarked on or before the 10th day of the month following this reporting period. If you have any questions regarding this tax return, please call the Excise Tax Section at (855) 466-3921. American LegalNet, Inc. www.FormsWorkFlow.com Schedule A Beer and Malt Beverages in Barrels Schedule A ­ Barrel Beer and Malt Beverages 1. Sold in Ohio and/or consumed on premises in Ohio Tax rate 2. Multiply totals on line 1 by tax rate $ $ 1.395 $ $ 2.79 $ $ 5.58 $ $ $ 2.376 $ $ .951 $ ALC 83 Rev. 5/15 Page 2 Number of Barrels and Sizes 1/4 1/2 1 13.2 Gal. Keg 4-5L Case 3. Tax liability (total of amounts on line 2) ­ carry forward to line 1 on page 1 Schedules B and B1 Beer and Malt Beverages in Containers Other Than Barrels Schedule B ­ Case Beer and Malt Beverages 1. Sold in Ohio and/or consumed on premises in Ohio Tax rate 2. Multiply totals on line 1 by tax rate 3. Tax liability (total of amounts on line 2) $ $ .403 $ $ $ .605 $ $ .706 $ $ .235 $ $ .202 $ Number of Cases and Sizes 24/12 12/32 12/40 24/7 12/12 Schedule B1 ­ Case Beer and Malt Beverages 1. Sold in Ohio and/or shipped to a personal consumer in Ohio Tax rate 2. Multiply totals on line 1 by tax rate 3. Tax liability (total of amounts on line 2) $ Number of Cases and Sizes 24/12 12/32 12/40 24/7 12/12 $ .403 $ $ $ .605 $ $ .706 $ $ .235 $ $ .202 $ 4. Total tax liability (add Schedule B line 3 and Schedule B1 line 3) - carry forward to line 2 on page 1 $ American LegalNet, Inc. www.FormsWorkFlow.com