[ { "page": 1, "items": [ { "page": 1, "type": "TEXT", "location": { "l": 22.32, "t": 767.28, "r": 134.16, "b": 710.88 }, "text": "73A525 (7-24)\nCommonwealth of Kentucky\nDEPARTMENT OF REVENUE\nTEAM KENTUCKY", "reading_order": 0 }, { "page": 1, "type": "TEXT", "location": { "l": 448.08, "t": 767.28, "r": 576.72, "b": 722.64 }, "text": "FOR DEPARTMENT USE ONLY\n* Tax * / Mo. / Yr.", "reading_order": 1 }, { "page": 1, "type": "TEXT", "location": { "l": 167.04, "t": 724.32, "r": 442.32, "b": 699.36 }, "text": "File with the Department of Revenue on or before the 20th of the month following the month for which the report is made.", "reading_order": 2 }, { "page": 1, "type": "TEXT", "location": { "l": 20.88, "t": 690.96, "r": 588.72, "b": 668.4356 }, "text": "Name and Address of Distiller, Rectifier or Bottler Revenue Account Number ________ State License Number ________ Report for Month of _______, 20______", "reading_order": 3 }, { "page": 1, "type": "TEXT", "location": { "l": 20.88, "t": 668.4356, "r": 588.72, "b": 623.3867 }, "text": "Part I—Distilled Spirits Excise Tax Report Number of Cases", "reading_order": 4 }, { "page": 1, "type": "TEXT", "location": { "l": 91.86, "t": 645.9111, "r": 588.72, "b": 623.3867 }, "text": "3 Gal. 2.4 Gal. 12 Liters 10.5 Liters 9.6 Liters 9 Liters 1 Gallon Other (specify)", "reading_order": 5 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 623.3867, "r": 588.72, "b": 600.8622 }, "text": "Gift Shop or other retail outlet sales to consumers and retailers in Kentucky (per instructions).................................................", "marker": "1.", "list_id": "L1", "level": 0, "reading_order": 6 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 600.8622, "r": 588.72, "b": 578.3378 }, "text": "Samples taken from Kentucky inventory.........................................................", "marker": "2.", "list_id": "L1", "level": 0, "reading_order": 7 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 578.3378, "r": 588.72, "b": 555.8133 }, "text": "Other (per instructions).................................................", "marker": "3.", "list_id": "L1", "level": 0, "reading_order": 8 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 398.1422, "r": 588.72, "b": 375.6178 }, "text": "Total amount due (add lines 9 and 10)................................................. $ $", "marker": "11.", "list_id": "L1", "level": 0, "reading_order": 9 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 375.6178, "r": 588.72, "b": 353.0933 }, "text": "☐ Check the box if Tax Type 20 Excise Tax was paid online. (Payment ID# _______ )", "list_id": "L1", "level": 0, "reading_order": 10 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 555.8133, "r": 588.72, "b": 533.2889 }, "text": "Total subject to excise tax (add lines 1, 2 and 3).................................................", "marker": "4.", "list_id": "L1", "level": 0, "reading_order": 11 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 533.2889, "r": 588.72, "b": 510.7644 }, "text": "Less quantities returned by retailers and consumers (complete schedule on reverse side) ..", "marker": "5.", "list_id": "L1", "level": 0, "reading_order": 12 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 510.7644, "r": 588.72, "b": 488.24 }, "text": "Balance subject to excise tax (line 4 minus line 5).................................................", "marker": "6.", "list_id": "L1", "level": 0, "reading_order": 13 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 488.24, "r": 588.72, "b": 465.7156 }, "text": "Tax rate per case................................................. $ 5.76 $ 4.61 $ 6.09 $ 5.33 $ 4.87 $ 4.57 $ 1.92", "marker": "7.", "list_id": "L1", "level": 0, "reading_order": 14 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 465.7156, "r": 588.72, "b": 443.1911 }, "text": "Excise tax applicable (line 6 multiplied by line 7)................................................. $ $ $ $ $ $ $ $ $ $ $ $", "marker": "8.", "list_id": "L1", "level": 0, "reading_order": 15 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 443.1911, "r": 588.72, "b": 420.6667 }, "text": "Total excise tax due (total of all items on line 8)................................................. 20 $", "marker": "9.", "list_id": "L1", "level": 0, "reading_order": 16 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 420.6667, "r": 588.72, "b": 398.1422 }, "text": "Penalty and interest due (per instructions)................................................. $ $", "marker": "10.", "list_id": "L1", "level": 0, "reading_order": 17 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 353.0933, "r": 588.72, "b": 330.5689 }, "text": "Part II—Distilled Spirits Wholesale Sales Tax Report", "list_id": "L1", "level": 0, "reading_order": 18 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 330.5689, "r": 588.72, "b": 308.0444 }, "text": "Gross receipts from wholesale sales of spirits to consumers and retailers in Kentucky (excluding 11% wholesale sales tax)................................................. $ $", "marker": "12.", "list_id": "L1", "level": 0, "reading_order": 19 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 308.0444, "r": 588.72, "b": 285.52 }, "text": "Total wholesale sales tax due (line 12 multiplied by .11)................................................. 22 $", "marker": "13.", "list_id": "L1", "level": 0, "reading_order": 20 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 285.52, "r": 588.72, "b": 262.9956 }, "text": "Penalty and interest due (per instructions)................................................. $ $", "marker": "14.", "list_id": "L1", "level": 0, "reading_order": 21 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 262.9956, "r": 588.72, "b": 240.4711 }, "text": "Total amount due (add lines 13 and 14)................................................. $ $", "marker": "15.", "list_id": "L1", "level": 0, "reading_order": 22 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 240.4711, "r": 588.72, "b": 217.9467 }, "text": "☐ Check the box if Tax Type 22 Wholesale Sales Tax was paid online. (Payment ID# _______ )", "list_id": "L1", "level": 0, "reading_order": 23 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 217.9467, "r": 588.72, "b": 195.4222 }, "text": "Part III—Distilled Spirits Case Sales Tax Report (Note: This Part applies to self-distributed sales by Class B distillers only)", "list_id": "L1", "level": 0, "reading_order": 24 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 195.4222, "r": 588.72, "b": 172.8978 }, "text": "Cases subject to tax (total number of cases included in line 1 of Part I above self-distributed by Class B distillers)................................................. $ $", "marker": "16.", "list_id": "L1", "level": 0, "reading_order": 25 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 172.8978, "r": 588.72, "b": 150.3733 }, "text": "Total case sales tax due (line 16 multiplied by .05)................................................. 19 $", "marker": "17.", "list_id": "L1", "level": 0, "reading_order": 26 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 150.3733, "r": 588.72, "b": 127.8489 }, "text": "☐ Check the box if Tax Type 19 Distilled Spirits Case Sales Tax was paid online. (Payment ID# _______ )", "list_id": "L1", "level": 0, "reading_order": 27 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 127.8489, "r": 588.72, "b": 105.3244 }, "text": "Part IV—Total Amount Due with Monthly Report of Distillers, Rectifiers or Bottlers", "list_id": "L1", "level": 0, "reading_order": 28 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 20.88, "t": 105.3244, "r": 588.72, "b": 82.8 }, "text": "Total distilled spirits excise, wholesale sales, and case sales tax due (add lines 11, 15, and 17)................................................. $ $", "marker": "18.", "list_id": "L1", "level": 0, "reading_order": 29 }, { "page": 1, "type": "TEXT", "location": { "l": 488.4, "t": 76.32, "r": 589.92, "b": 63.6 }, "text": "Continued on Page 2", "reading_order": 30 } ] }, { "page": 2, "items": [ { "page": 2, "type": "TEXT", "location": { "l": 554.88, "t": 770.4, "r": 589.68, "b": 757.2 }, "text": "Page 2", "reading_order": 0 }, { "page": 2, "type": "TEXT", "location": { "l": 22.08, "t": 730.56, "r": 589.68, "b": 697.008 }, "text": "SCHEDULE OF DISTILLED SPIRITS RETURNED BY KENTUCKY WHOLESALERS AND RETAILERS/CONSUMERS", "reading_order": 1 }, { "page": 2, "type": "TEXT", "location": { "l": 22.08, "t": 697.008, "r": 589.68, "b": 629.904 }, "text": "Name of Wholesaler or Retailer/Consumer Date Returned Number of Cases", "reading_order": 2 }, { "page": 2, "type": "TEXT", "location": { "l": 135.6, "t": 663.456, "r": 589.68, "b": 629.904 }, "text": "3 Gal. 2.4 Gal. 12 Liters 10.5 Liters 9.6 Liters 9 Liters 1 Gallon Other (specify)", "reading_order": 3 }, { "page": 2, "type": "TITLE", "location": { "l": 245.04, "t": 368.4, "r": 368.64, "b": 353.76 }, "text": "IMPORTANT NOTICE", "reading_order": 4, "level": 2 }, { "page": 2, "type": "TEXT", "location": { "l": 184.08, "t": 348, "r": 429.12, "b": 333.84 }, "text": "Make check(s) payable to Kentucky State Treasurer.", "reading_order": 5 }, { "page": 2, "type": "TEXT", "location": { "l": 67.2, "t": 323.28, "r": 545.76, "b": 310.08 }, "text": "Mail report and check(s) to: Excise Tax Section, Department of Revenue, Frankfort, Kentucky 40619", "reading_order": 6 }, { "page": 2, "type": "TEXT", "location": { "l": 22.32, "t": 275.04, "r": 590.16, "b": 252.24 }, "text": "I, the undersigned, a principal officer of the above-named licensee, certify that I have examined this report and it is, to the best of my knowledge and belief, a true, correct and complete report.", "reading_order": 7 }, { "page": 2, "type": "TEXT", "location": { "l": 138, "t": 217.68, "r": 176.16, "b": 206.88 }, "text": "Signature", "reading_order": 8 }, { "page": 2, "type": "TEXT", "location": { "l": 361.2, "t": 217.68, "r": 379.2, "b": 207.36 }, "text": "Title", "reading_order": 9 }, { "page": 2, "type": "TEXT", "location": { "l": 509.04, "t": 217.44, "r": 529.44, "b": 207.6 }, "text": "Date", "reading_order": 10 } ] } ]