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pdfOMB No. 1513-0090 (03/31/2009)
1. SERIAL NUMBER
DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
EXCISE TAX RETURN – ALCOHOL AND TOBACCO (PUERTO RICO)
3. AMOUNT OF PAYMENT
(Prepare in duplicate – See instructions below)
2. FORM OF PAYMENT
CHECK
MONEY ORDER
EFT
4. RETURN COVERS (Check one)
PREPAYMENT
$
OTHER (Specify)
NOTE: PLEASE MAKE CHECKS OR MONEY ORDERS
PAYABLE TO THE ALCOHOL AND TOBACCO TAX AND
TRADE BUREAU (SHOW EMPLOYER IDENTIFICATION
NUMBER ON ALL CHECKS OR MONEY ORDERS) IF
YOU SEND A CHECK, SEE PAPER CHECK CONVERSION
NOTICE BELOW.
BEGINNING
PERIOD
ENDING
FOR TTB USE ONLY
5. DATE PRODUCTS TO BE REMOVED (For Prepayment Returns Only:)
6. EMPLOYER IDENTIFICATION NUMBER
7. PLANT, REGISTRY, OR PERMIT NUMBER
TAX
$
PENALTY
8. NAME AND ADDRESS OF TAXPAYER (Include ZIP Code)
INTEREST
TOTAL
$
EXAMINED BY:
DATE EXAMINED:
CALCULATION OF TAX DUE (Before making entries on lines 18 – 21, complete Schedules A and B)
PRODUCT
AMOUNT OF TAX
(a)
(b)
$
9. DISTILLED SPIRITS
10. WINE
11. BEER
12. CIGARS
13. CIGARETTES
14. CIGARETTE PAPERS AND/OR CIGARETTE TUBES
15. CHEWING TOBACCO AND/OR SNUFF
16. PIPE TOBACCO AND/OR ROLL-YOUR-OWN TOBACCO
$
17. TOTAL TAX LIABILITY (Total of lines 9-16)
18. ADJUSTMENTS INCREASING AMOUNT DUE (From line 29)
$
19. GROSS AMOUNT DUE (Line 17 plus line 18)
20. ADJUSTMENTS DECREASING AMOUNT DUE (From line 34)
$
21. AMOUNT TO BE PAID WITH THIS RETURN (Line 19 minus line 20)
Under penalties of perjury, I declare that I have examined this return (including any accompanying explanations, statements, schedules, and forms) and to
the best of my knowledge and belief it is true, correct, and includes all transactions and tax liabilities required by law or regulations to be reported.
23. SIGNATURE
22. DATE
24. TITLE
SCHEDULE A – ADJUSTMENTS INCREASING AMOUNT DUE
AMOUNT OF ADJUSTMENTS
EXPLANATION OF INDIVIDUAL ERRORS OR TRANSACTIONS
(a)
(b) TAX
(c) INTEREST
(d) PENALTY
$
25.
$
26.
27.
28. SUBTOTALS OF COLUMNS (b), (c) AND (d)
$
$
$
$
29. TOTAL ADJUSTMENTS INCREASING AMOUNT DUE (Line 28, Col (b) + (c) + (d)) Enter here and on line 18.
SCHEDULE B – ADJUSTMENTS DECREASING AMOUNT DUE
AMOUNT OF ADJUSTMENTS
EXPLANATION OF INDIVIDUAL ERRORS OR TRANSACTIONS
(a)
(b) TAX
(c) INTEREST
30.
$
$
$
$
$
31.
32.
33. SUBTOTALS OF COLUMNS (b) and (c)
34. TOTAL ADJUSTMENTS DECREASING AMOUNT DUE (Line 33, Col (b) + (c)) Enter here and on line 20.
Notice to Customers Making Payment by Check
If you send us a check, it will be converted into an electronic funds transfer (EFT). This means we will copy your check and use the account information on it to electronically
debit your account for the amount of the check. The debit from your account will usually occur within 24 hours, and will be shown on your regular account statement.
You will not receive your original check back. We will destroy your original check, but we will keep the copy of it. If the EFT cannot be processed for technical reasons, you
authorize us to process the copy in place of your original check. If the EFT cannot be completed because of insufficient funds, we may try to make the transfer up to 2 times.
TTB F 5000.25 (07/2007)
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35. ADDITIONAL INSTRUCTIONS (Reference by Item Number)
36. ELIGIBILITY FOR COVER OVER
a. DISTILLED SPIRITS
COLUMN 1
PROOF GALLONS (92% Rum)
COLUMN 2
PROOF GALLONS (other)
TAXES PAID ON PRODUCTS MEETING 50%
VALUE ADDED REQUIREMENT
OTHER
b. WINE, BEER, TOBACCO PRODUCTS OR
CIGARETTE PAPERS AND TUBES
$
$
37. NUMBER OF LARGE CIGARS UPON WHICH TAX WAS COMPUTED, BY STATISTICAL CLASSES
(a) CLASS - A
(b) CLASS - B
+
(e) CLASS - E
(c) CLASS - C
+
(f) CLASS - F
+
(d) CLASS - D
+
(g) CLASS - G
+
=
(h) CLASS - H
+
=
38. RECEIPT OF DISTRICT DIRECTOR (INVESTIGATIONS) PUERTO RICO OPERATIONS
a. DATE RECEIVED b. AMOUNT RECEIVED
c. BY TTB OFFICER (Signature and Official Title)
$
INSTRUCTIONS
1. PREPARATION AND FILING.
(a) DISTILLED SPIRITS, WINE AND BEER - Prepare in duplicate. The return
must cover taxable shipments to the United States plus any other tax liabilities
incurred or discovered during the tax period. File the original and duplicate with
remittance covering the full amount of tax, with the District Director
(Investigations) Puerto Rico Operations, TTB, San Juan, PR (see instruction
14 for address). The District Director (Investigations) Puerto Rico Operations
will acknowledge receipt in Item 38 and return the duplicate copy for your files.
9. SCHEDULE B. Use Schedule B to report adjustments decreasing the amount due
(for example, an error in a previous return period that resulted in an overpayment of
tax). Prepayments of tax, claims approved for credit of tax, and other authorized
adjustments must be reported in Schedule B. You may carry over to Schedule B of
your next tax return the unused portion of any approved tax credits or adjustments.
10. EXPLANATION OF ADJUSTMENTS. You must fully explain adjustments reported
in Schedules A and B. Identify any prepayment by serial number of the tax return on
which the tax was prepaid. Identify approved claims by claim number. In all other
cases, you must enter, as a minimum, the date of the transaction (the date of an error,
(b) TOBACCO PRODUCTS, AND CIGARETTE PAPERS AND TUBES - Prepare
the date a shortage was found, etc.), the identity and quantity of the product involved
in duplicate. The return must cover taxable shipments to the United States plus
in the adjustment, and the reason for the adjustment. If necessary, use the space
any other tax liabilities incurred or discovered during the tax period. File the original
above and/or attach a separate sheet to explain adjustments fully.
and duplicate with remittance covering the full amount of tax, with the District
Director (Investigations) Puerto Rico Operations, TTB, San Juan, PR (see
11. INTEREST. The law provides for the payment of interest on underpayments and
instruction 14 for address). After acknowledging receipt in Item 38, the District
overpayments of tax. Interest, if applicable, will be computed at the rate
Director shall retain the original and return the duplicate copy to the taxpayer.
prescribed by 26 U.S.C. 6621 and reported as a separate entry in Schedule A or
B. To avoid paying interest on unexplained shortages of bottled distilled spirits,
2. A separate TTB F 5000.25 must be prepared for each premises from which you
you must report the shortage on the tax return covering the period in which you
make shipments to the United States subject to tax.
discovered the shortage. Interest is not allowed on adjustments involving the
3. TTB F 5000.25 must be used as both a prepayment tax return and a deferred
prepayment of tax or approved claims for credit of tax (unless the approved claim
payment tax return.
specifically authorized such interest).
4. ITEM 1. Begin with January "1" of each year. Use a separate series of numbers
with the prefix "P" to designate prepayment returns. Begin with "P-1" to designate
the first prepayment return filed on or after January 1 of each year.
5. ITEM 6. Enter your employer identification number here and on all checks or
money orders which accompany your return. If you have not been assigned an
employer identification number, you must obtain and file Form SS-4 with your local
Internal Revenue Service office.
6. If this form contains pre-printed information in items 6, 7, or 8, and the information
is incorrect, make the necessary corrections by crossing out any errors and
printing the correct information in the same area. If there is no pre-printed
information in these areas, print or type the required information in the spaces
provided.
12. Enter "NONE" in Schedule A or Schedule B if there is no transaction.
13. Item 36. DISTILLED SPIRITS- Indicate in column 1 the total proof gallons, other
than articles for which drawback will be claimed under 26 U.S.C. 5134, in which
at least 92 percent of the alcoholic content is rum. In column 2 show the total
proof gallons of all other spirits.
WINE, BEER, TOBACCO PRODUCTS, AND CIGARETTE PAPERS AND
TUBES. Indicate in column l the total amount of excise taxes entitled for cover over
in which the product meets the 50 percent value added requirement under 26
U.S.C. 7652(d)(1). In column 2 show the total of all other taxes.
7. LINES 9-21. Show on the appropriate line or lines the amount of tax being
prepaid or, if the return covers a tax return period, the tax liability incurred during
the period. If the return covers a tax return period, you must include at lines 9-16
all tax liabilities incurred during the period even if you have already prepaid the tax.
(You will show prepayments in Schedule B as adjustments decreasing the
amount due).
8. SCHEDULE A. Use Schedule A to report adjustments increasing the amount
due (for example, an error in a previous return period that resulted in an
underpayment of tax).
Compute the interest on underpayments from the due date of the return in error to
the date of payment. Compute the interest on overpayments from the date of
overpayment to the due date of the return on which the credit is taken.
14. Payment must accompany this form except when the payment is by electronic
funds transfer (EFT). Send payment to:
DISTRICT DIRECTOR (INVESTIGATIONS) PUERTO RICO OPERATIONS
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU
STE 310 TORRE CHARDON
350 CARLOS CHARDON AVE
SAN JUAN, PR 00918-2124
PAPERWORK REDUCTION ACT NOTICE
This request is in accordance with the Paperwork Reduction Act of 1995. The purpose of this information is to identify taxpayers, the period covered, and the amount of tax due for each tax return. The
information is used by the Government to ensure that the correct tax payment was made and received. The information is mandatory by statute (26 U.S.C., 5061, 5703).
The estimated average burden associated with this collection is .75 hours per respondent or recordkeeper depending on individual circumstances. Comments concerning the accuracy of this burden estimate
and suggestions for reducing this burden should be directed to the Reports Management Officer, Regulations and Rulings Division, Alcohol and Tobacco Tax and Trade Bureau, Washington, D.C. 20220.
An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a current, valid OMB control number.
TTB F 5000.25 (07/2007)
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File Type | application/pdf |
File Title | Microsoft Word - F 5000.25 Pre-Printed Excise Tax Return A-T Puerto Rico.dot |
Author | yywhitehea |
File Modified | 2007-08-03 |
File Created | 2005-05-03 |