Nevada Department of Taxation Forms & Instructions

Nevada Liquor Excise Tax Return — EXC-F067 (combo form+instructions)

TRANSACTIONS DURING THE MONTH IN WINE GALLONS

MALT BEVERAGE ALCOHOLIC BEVERAGES OFFICE USE ONLY

Postmark: Ck. No: $ Initials: Keg or Draught Bottled or Canned Total Malt Beverage .5% to 14% 14.1% to 22% 22.1% to 80% 1. Total Gross Gallons *please see revised instructions on page 2 2. Credit: Breakage, Loss- LIQ-2 3. Credit: Exports or tax paid by manufacturer- LIQ-3 4a. Credit: Military Sales- LIQ-4a 4b. Credit: Airline Sales- LIQ-4b 5. TOTAL DEDUCTIONS 6. TOTAL TAXABLE GALLONS 7. Tax Rates for liquor categories. $ .16 per gal. $ .70 per gal. $ 1.30 per gal. $ 3.60 per gal. 8. Gross Tax (taxable gallons times tax rate). $ 9. Discount of 0.25% allowed if payment is postmarked on or before the 15th of the month following activity. - 10. Adjusted Tax amount due and payable with this return. $ 11. Less credits approved by the Department. Credit notification from the Department must be attached. - 12. Penalty (see instructions for rate). $ 13. Interest 0.75% per month due on payments postmarked after the 20th of the month. $ 14. Add Liabilities established by the Department. $ 15. Total amount due and payable. $ 16. Total amount remitted with this return. MAKE CHECK PAYABLE TO THE NEVADA DEPARTMENT OF TAXATION. I hereby certify that this return, including all attached schedules has been examined by me and to the best of my knowledge and belief is a true, correct and complete return; that I am the Importer, Manufacturer, or Officer of the above business and duly qualified and authorized to verify this return. Reported By Signed Checked By Title Phone No

LIQUOR TAX RETURN

Mail Returns to: Nevada Department of Taxation 3580 Arrowhead Drive Carson City, NV 89706 Make checks payable to: Nevada Department of Taxation Business or Individual's Name Location Address City, State, Zip This return can be filed on My Nevada Tax at https://MyNVTax.nv.gov and all calculations will be performed for you. Check this box if this is an amended return for the specified filing period $ A RETURN MUST BE FILED EACH MONTH WHETHER OR NOT LIQUOR IS IIMPORTED OR MANUFACTURED Due on or Before: Date Paid: LIQ: - -

LIQ-1 LIQUOR EXCISE TAX RETURN INSTRUCTIONS Reports of licensees must be in wine gallons. For Wine and Malt Beverages the quantity in liters must be multiplied by 0.26417 to determine the equivalent quantity in wine gallons. For Distilled Spirits, to c onvert liters to wine gallons, the quantity in liters must be multiplied by 0.264172 to determine the equivalent quantity in wine gallons. The resulting figure must be rounded to the nearest one -hundredth of a gallon. Line 1 Enter the total gross gallons imported, purchased from a manufacturer, rectifier, or brewer and/or manufactured by you, rounded to the hundredth decimal (2). This is to be verified by supplier reports for importers; manufacturers must include copies of TTB tax returns/reports. Importers breakdown shipments received on LIQ-1a (page 3), Manufacturers use LIQ-1b (page 4) for alcohol removed from the federally bonded premises and LIQ-1c (page 5) for alcohol packaged for immediate sale. Line 2 Credit for shipments lost, stolen or damaged in transit, or damaged or spoiled on the premises less the 0.25% discount taken previously. List this on Form LIQ-2 (page 6) and include all applicable documentation of the incident. This can be used by Manufacturers and Importers. Line 3 Credit for liquor exported and sold outside this State, less 0.25% discount taken previously. List on Form LIQ-3a (page 7) and enclose a copy of the original invoice with this report. Or, credit for liquor purchased from an in-state manufacturer, less 0.25% discount taken previously. List on Form LIQ -3b (page 8) and enclose a copy of the original invoice with this report. In state manufacturers should only use this line for exports. Line 4 Credit for liquor sold to airlines, permissible persons or to military bases less the 0.25% discount taken previously. List this on supplemental Form LIQ-4a (page 9) or LIQ-4b (page 10) and include invoices to qualifying parties. This can only be used by Importers. Line 5 Total of lines 2-4b Line 6 Subtract the quantity on line 5 from quantity on line 1 for total taxable gallon s. Line 8 Multiply gallons shown on line 6 by tax rate shown on line 7 for the gross tax. Line 9 The excise tax imposed by this Chapter is due and payable on or before the 20th day of the following month. If all such taxes are paid on or before the 15thday of the following month, a discount in the amount of 0.25% of the tax shall be allowed. If tax is not paid by date due a penalty of 10% will be added, together with interest at the rate of 0.75% per month, or any fraction thereof, from the date due until paid. Line 10 Subtract the figure on line 9 from gross tax on line 8 for adjusted tax amount.

Line 11

Subtract credits (attach Department notification of credit to this return). Line 12 If this retur n will not be submitted/postmarked and the taxes pai d on or before the due date as shown on the face of this return, the amount of penalty due is based on the number of days late the payment is made per NAC 360.395. The maximum penalty amount is 10%. Number of D ays L ate Penalty Percentage Multiply by: 1 - 10 2% 0.02 11 - 15 4% 0.04 16 - 20 6% 0.06 21- 30 8% 0.08 31 + 10% 0.10 Determine the number of days late the payment is, and multiply the net tax owed by the appropriate rate based on the table above. The result is the amount of penalty that should be entered. For example, the taxes were due January 31, but not paid until February 15. The number of days late is 15 so the penalty is 4%. Line 13 To calculate interest for each month multiply Line 10 x 0.75% (or .0075) if postmarked after the 20th of the month following Line 14 Add the amount of any Liability that has been established by the Department. Attach Department notificati on of amount due. Line 15 The total amount due and payable with this return. Brew Pubs must report gallons of malt beverages manufactured and sold in this reporting period on form LIQ -1d (page 11). Estate Distillers m ust report spirits manufactured for ex portation or sold at retail on form LIQ- 1e (page 12). activity.

LIQ-1a BEER, WINE AND LIQUOR IMPORTED INTO NEVADA INCLUDE COPIES OF ALL INVOICES FROM SUPPLIERS WITH THIS RETURN (ENTER LIQUOR REMOVED FROM THE FEDERALLY BONDED PREMISES ON PAGE 4 ) Invoice Date Supplier's Name Certificate of Compliance Holder Certificate Number. Invoice Number Beer Gallons .5 through 14% Gallons 14.1 to 22% Gallons 22.1 to 80% Gallons Subtotal Imports Grand Total Imports. Enter on Line 1, Page 1 -- Provide additional pages as needed. -LIQ:

LIQ-1b BEER, WINE AND LIQUOR MANUFACTURED IN NEVADA AND REMOVED FROM THE FEDERALLY

BONDED PREMISES INCLUDE COPIES OF ALL FEDERAL EXCISE TAX REPORTS WITH THIS RETURN

Product Name Date Entered into Bond Beer Gallons .5 through 14% Gallons 14.1 to 22% Gallons 22.1 to 80% Gallons Total Gallons Withdrawn This Month Balance in Bond Total gallons removed from bonded premises this month --LIQ: -- If beer, wine, or spirits have also been manufactured for immediate sale, add total to LIQ-1c (page 5), otherwise this number goes on Line1 of Page 1.

LIQ-1c BEER, WINE AND LIQUOR MANUFACTURED IN NEVADA & PACKAGED FOR

IMMEDIATE SALE IN NEVADA

INCLUDE COPIES OF ALL FEDERAL EXCISE TAX REPORTS WITH THIS RETURN

Date Product Name Beer Gallons .5 through 14% Gallons 14.1 to 22% Gallons 22.1 to 80% Gallons Total Gallons manufactured for immediate sale Total Gallons removed from bond (Page 4) Grand Total of manufactured gallons Enter on Line 1 of Page 1 --LIQ: --

LIQ-2 MONTHLY REPORT OF LOSS Firm Name: Street: City: State: Zip Code: This form is a supplemental page to LIQ-1. Excise tax credit (Line 2, LIQ-1) for alcoholic beverages lost, stolen or damaged in transit or spoiled on premises. (NRS 3 69.370) Attach copies of all supporting loss claims which have been filed with carriers, shippers, etc.

DATE EXPLAIN TYPE OF LOSS, SHIPPER, BRAND NAME, ETC.

MALT BEVERAGES ALCOHOLIC BEVERAGES KEG GALLONS BOTTLE OR CAN GALLONS GALLONS .5% to 14%

GALLONS 14.1% to 22%

GALLONS

22.1% to 80% GALLON TOTALS: LESS .25% FORMERLY DISCOUNTED: TOTAL, ENTER ON LINE 2 OF TAX RETURN: -- LIQ: -

LIQ-3a MANUFACTURER OR WHOLESALER MONTHLY REPORT OF EXPORTS This form is a supplemental page to LIQ-1. Excise tax credit (Line 3 on LIQ-1) for alcoholic beverages exported from the State of Nevada (NRS 369.370).

EXPORT DATE BUSINESS NAME AND ADDRESS WHERE PRODUCT WAS EXPORTED

MALT BEVERAGES ALCOHOLIC BEVERAGES KEG GALLONS BOTTLE OR CAN GALLONS GALLONS .5% to 14%

GALLONS 14.1% to 22%

GALLONS

22.1% to 80% GALLON TOTALS: LESS .25% FORMERLY DISCOUNTED: TOTAL, ENTER ON LINE 3 OF TAX RETURN: LIQ: --

This form is a supplemental page to LIQ-1. Excise tax credit (Line 3 on LIQ-1) for alcoholic beverages exported from the State of N evada (NRS 369.370).

DATE OF PURCHASE BUSINESS NAME AND ADDRESS OF MANUFACTURER PURCHASED PRODUCT FROM

MALT BEVERAGES ALCOHOLIC BEVERAGES KEG GALLONS BOTTLE OR CAN GALLONS GALLONS .5% to 14%

GALLONS 14.1% to 22%

GALLONS

22.1% to 80% GALLON TOTALS: LESS .25% FORMERLY DISCOUNTED: TOTAL, ENTER ON LINE 3 OF TAX RETURN: LIQ-3b WHOLESALER PURCHASES FROM AN IN-STATE MANUFACTURER LIQ: --

LIQ-4a LIQUOR WHOLESALER MONTHLY

REPORT OF MILITARY SALES

Firm Name: Street: City: State: Zip Code: Excise tax credit (Line 4a on LIQ-1) for alcoholic beverages sold to MILITARY UNITS in Nevada, who qualify as "Instrumentalities of the Armed Forces of the United States" (NRS 369.335) Attach copies of all supporting invoices.

DATE NAME AND LOCATION SHIPPED TO BASE, POST, STORE, INSTALLATION

MALT BEVERAGES ALCOHOLIC BEVERAGES KEG GALLONS BOTTLE OR CAN GALLONS GALLONS .5% to 14%

GALLONS 14.1% to 22%

GALLONS

22.1% to 80% GALLON TOTALS: LESS .25% FORMERLY DISCOUNTED: TOTAL - ENTER ON LINE 4a OF TAX RETURN: LIQ: --

LIQ-4b LIQUOR WHOLESALER MONTHLY REPORT OF SALES TO AIRLINES Firm Name: Street: City: State: Zip Code: Excise tax credit (Line 4b on LIQ-1) for alcoholic beverages exported from the State of Nevada (NRS 369.175) Attach copies of all supporting invoices.

DATE NAME OF AIRLINE MALT BEVERAGES ALCOHOLIC BEVERAGES KEG GALLONS BOTTLE OR CAN

GALLONS GALLONS .5% to 14 %

GALLONS 14.1% to 22%

GALLONS

22.1% to 80% GALLON TOTALS: LESS .25% FORMERLY DISCOUNTED: TOTAL, ENTER ON LINE 4b OF TAX RETURN: LIQ: --

LIQ-1d BREW PUB MONTHLY REPORT Gallons of malt beverages manufactured and sold in this reporting period (complete one report per licensed location) Entity Name: Street: City/State/Zip: 1. Total gallons of malt beverage manufactured in this reporting period (amount must represent the total gallons per licensed location): __________________ 2. Total gallons of malt beverage sold at a special event this reporting period (amount must represent the total gallons for each brew pub you operate in Nevada): __________________ 3. Total gallons of malt beverage sold this reporting period at retail (not for resale), manufactured on or off premises for consumption on premises: __________________ 4. Total gallons of malt beverage sold at retail (not for resale) for this reporting period; sold in packages sealed on premises for each brew pub you operate - manufactured on the premises for consumption off the premises: __________________ 5. Total gallons of malt beverages manufactured on site for off site consumption sold/transferred to retail liquor store location(s) under common ownership: __________________ 6. Total gallons of malt beverage manufactured for sale to a wholesaler located outside of Nevada: __________________ 7. Total amount, in gallons, sold from Lines 2-6: __________________ 8. From Line 7, how many gallons sold in kegs: __________________ LIQ: --

LIQ-1e ESTATE DISTILLERS MONTHLY REPORT This form is a supplemental page to LIQ-1. Spirits manufactured for exportation sold to an in-state-wholesaler or sold at retail (not for resale) for off premise consumption Entity Name: Street: City/State/Zip: 1. Total milliliters of spirits, manufactured for exportation for this reporting period (total must represent the total milliliters of spirits at all estate distilleries you operate in Nevada): ___________________ 2. Total milliliters of spirits sold at the estate distillery to a person who holds a Nevada wholesale dealers license (total must represent the total milliliters of spirits at all estate distilleries you operate in Nevada): __________________ 3. Total milliliters of spirits sold at retail for off premise consumption for this reporting period (total must represent the total milliliters of spirits at all estate distilleries you operate in Nevada): _____________ LIQ: - -

Source: official text