Main Navigation
Form 835 Fillable Domestic Farm Winery/Domestic Microbrewery/Domestic Cider Return of Liquor Sold
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)Amended Return Final Return (LICENSE CANCELED) New License Number Cider Cider means vinous liquor that is made from the Malt Liquor means any liquid containing more than Vinous Liquor means any liquid containing more than $ 0 16 $ 0 84 (8) ounces for containers containing more than eight (8) (Click to clear page) Reset Page (Click to print) Print (Click to print) Print (Click to select) Unchecked (Click to select) Unchecked (Click to select) Unchecked (Click to select) Unchecked (Click to select: 1) Unchecked (Click to select: 1) Unchecked (Click to select: 2) Unchecked (Click to select: 2) Unchecked (Click to select: 3) Unchecked (Click to select: 3) Unchecked (Click to select: Yes) Unchecked (Go to Definitions) Definitions (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (Type digits only) (Type MMDDYYYY digits only) 1 Gallons sold 2 Deductions total gallons: 24% or less by volume and malt/cider are preprinted on 3 TOTAL DEDUCTIONS (Add lines 2a through 2d) 4 Other Adjustments gain or loss 5 Taxable gallons sold to consumers/ 6 Tax Rates 7 Tax Due (Multiply line 5 by line 6) 8 TOTAL TAX DUE: (Add line 7 columns a b and c) 81 PM 80 RCVD a domestic farm winery a domestic microbrewery or a a Sold to military installations from Schedule B ADOR 11081 (9/13) ADOR 11081 (9/13) all substantiating documentation for at least four years amounts on line 4 Enter these amounts and not including liquids made by the process of apples including flavored sparkling and carbonated are correct and complete Arizona Form 835 Arizona Form 835 Arizona retail stores Attach a copy of your last Federal Bureau of Alcohol attach a written explanation AZ FORM 835 AZ FORM 835 Instructions b Exported from Arizona from Schedule C barrels to gallons: 31 gallons per barrel been eliminated from this report before the 20th day after the month the tax accrues Business (or dba) Name Business Location Address but not more than 7% of alcohol by volume c Sold to Arizona wholesalers from Schedule D Check only one box: Vinous Check only one box: Vinous Malt Cider Check only one box: Vinous Malt Cider CIDER cider and cider made from condensed apple must that containing eight (8) ounces or less and for each eight contains more than one half of 1% of alcohol by volume Continuation Sheet Convert liters to gallons: 1 liter = 0 264172 U S gallons Convert liters to gallons: 1 liter = 0 264172 U S gallons d Tax paid beverage returned Declaration of preparer (other than taxpayer) is based on all DEFINITIONS Department of Revenue for the rate on any vinous Department of Revenue Retain a copy of the form with distillation of such substances domestic cider producer who manufactures or produces Domestic Farm Winery / Domestic Microbrewery / Domestic Cider during the month E mail Address NEW Enter the amount for each column Fax No File a separate return for each license Read instructions beginning on page 4 prior to completing the return GALLONS GALLONSDATE NUMBER GENERAL INSTRUCTIONS: grains but not including liquids made by the process of hops or grains are used in the process of fermentation I have read this report and any attachments with it Under penalties identifi cation number If you pay a preparer to complete this return the information of which preparer has any knowledge INVOICE INVOICE is made and is delinquent if the tax is not paid within ten (10) days after the due date law imposes a 5% penalty per month if you fail to file Legal Business Name Line 1: Enter the total gallons sold for the month Line 2a: From Schedule B enter any tax free sales to Line 2b: From Schedule C enter any beverage sold out Line 2c: From Schedule D enter any beverage sold to Line 2d: Enter any tax paid for any beverage returned Line 3: Add lines 2a through 2d and enter the total Line 4: List any adjustments for the prior month and Line 5: Subtract line 3 from line 1 Add or subtract any Line 6: Tax rates for vinous with an alcohol content of line 7 Enter this amount as the Total Tax Due Line 7: For each column (a) (b) and (c) multiply the Line 8: Add the amounts in columns (a) (b) and (c) of Liquor License Number: Taxpayer I D Number: LITERS LITERSDATE NUMBER M D D Y Y Y Y M M D D Y Y Y Y M Mailing Address military installations during the month Schedule A has Month MONTH YYYY Name of Contact Person NEW NAME OF PURCHASER CITY STATE NAME OF PURCHASER/ NAME OF SUPPLIER/ NO OF NO OF NO OF NO OF No of Gallons No of Gallons normal alcoholic fermentation of the juice of sound ripe number of gallons entered on line 5 by the rate on line 6 of fermentation of grapes berries fruits vegetables or of perjury I declare that to the best of my knowledge and belief they of Revenue Include your taxpayer identifi cation number of state during the month of tax due on each return if your payment is late State on the premises and sells at retail or to retail licensees on the return A taxpayer identification number is either on your check one half of 1% alcohol by volume and is made by the one half of 1% alcohol by volume made by the process or not any tax is due File the original with the Arizona other licensed Arizona wholesalers during the month other substances but not including those liquids in which ounces Out of State Sales of Vinous and Malt/Cider Liquors During the Month Page 2 of 4 Page 3 of 4 Page 4 of 4 Period Beginning: Period Ending: Please mail to: Arizona Department of Revenue Liquor Tax PO Box 29019 Phoenix AZ 85038 9019 Prepare this return for each month regardless of whether preparer must sign the return and include his or her PREPARER S SIGNATURE TAXPAYER S OR AUTHORIZED AGENT S SIGNATURE PREPARER S TIN DATE TITLE DATE Previous 14 2049 (2/07) Previous 14 2049 (2/07) process of fermentation and not distillation of hops or proprietor with no employees PURCHASER CITY STATE RECEIVED Report vinous liquor in wine gallons Convert malt liquor Return of Liquor Sold REVENUE USE ONLY DO NOT MARK IN THIS AREA Sales to Licensed Arizona Wholesalers of Vinous and Malt/Cider Liquors During the Month Schedule B Schedule C Schedule D Schedule No Of Send payment with the return to the Arizona Department SHIPPED SHIPPED SHIPPED/ SPECIFIC INSTRUCTIONS: State State law imposes a penalty plus interest on the amount subject to inspection by the Department SUPPLIER CITY STATE Tax Free Sales of Vinous and Malt/Cider Liquors During the Month Telephone No The combined penalties however cannot exceed 25% the form Contact the Luxury Tax Section of the Arizona The Licensee or Authorized Agent must sign the return This return and the tax shown is due not later than the 20th day of the 1st month following the month for which this return Tobacco and Firearms return Total all continuation sheets Total all continuation sheets TOTAL GALLONS THIS MONTH: Enter here and on page 1 line 2a TOTAL GALLONS THIS MONTH: Enter here and on page 1 line 2b TOTAL GALLONS THIS MONTH: Enter here and on page 1 line 2c Total this sheet Total this sheet TOTAL THIS SHEET: Enter amounts on Schedule B C or D VINOUS with an alcohol content of more than 24% by volume within the State of Arizona You must file this return and pay the luxury tax if you are You must file this return monthly and pay the tax on or You must provide your taxpayer identifi cation number your Federal Employer Identification Number (EIN) or your Social Security Number (SSN) if you are a sole ZIP Code