ABC-1040 (Rev.12/20)
Alcoholic Beverage Control
109 SW 9
th
Street, 5
th
Floor
PO Box 3506
Topeka KS 66601-3506
Phone: 785-296-7015
Fax: 785-296-7185
www.ksrevenue.org/abcindex.html
WHO IS REQUIRED TO USE THIS FORM?
All Out-of-State Special Order Shipping licensees are required to file this return and report annually. You are
required to file this return and report even if you have no Kansas sales to report.
DUE DATE:
The tax return, payment and report are based on the calendar year and are due on or before the 15 day of
January following the end of the calendar year you are reporting.
th
INSTRUCTIONS TO COMPLETE THE SPECIAL ORDER SHIPPING GALLONAGE TAX RETURN:
1. Enter the report year, your FEIN, Special Order Shipping license number, DBA name, demographic and
contact information.
2. If you have no sales to report this year, check the box provided, enter a zero in the “Total Tax Due” box
and go to #5.
3. Enter the total number of GALLONS that you are reporting for the corresponding PRODUCT TYPE
(Fortified Wine or Light Wine).
4. Multiply each number of gallons by the corresponding TAX RATE and enter that amount in the
appropriate TAX DUE column.
5. Sign (or digitally sign) the return in the space provided.
INSTRUCTIONS TO COMPLETE THE SPECIAL ORDER SHIPPING ANNUAL REPORT OF SALES:
1. Enter your Special Order Shipping license number, the report year and enter your FEIN.
2. Complete your Special Order Shipping License DBA name, and contact information.
3. If you have no shipments to report this year, check the box “I have no shipments to Kansas consumers
this year” and go to #5.
4. To report shipments, complete information listed below for each order sent to Kansas consumers:
A. Shipment Date. Enter the date the product was shipped to the customer. Report all orders
received during the calendar year you are reporting for, even if they have not been shipped.
B. Tracking Number. Enter the tracking number for wine shipped. This will be required for all
shipments of wine beginning 2020.
C. Customer Name. Enter the name of the Kansas customer who placed the order.
D. Customer Address. Enter the Kansas mailing address where the wine was shipped.
E. City. Enter the city where the wine was shipped.
F. Zip Code. Enter the zip code where the wine was shipped.
G. Quantity Shipped. Enter the number of wine bottles you shipped.
H. Size Shipped. Enter the size you shipped. i.e. 750 ml
I. Gallons Shipped: (Round up to the nearest gallon).
Fortified Wine. Enter the number of gallons shipped.
Light Wine. Enter the number of gallons shipped.
J. Order Total. Enter the total amount charged for wine only. Do not include any gallonage, liquor
enforcement taxes, shipping charges nor charges for non-alcoholic products in this total.
5. Sign (or digitally sign) the report in the space provided.
There are three methods to file and pay your gallonage tax and submit your sales report:
Complete the ABC-1040 and mail with your check, money order or bank draft. You can email your
sales report to the address listed below.
FILING AND PAYMENT OF KANSAS SPECIAL ORDER SHIPPING GALLONAGE TAX RETURN:
File electronicallly through the KCSC and pay with your check, money order or bank draft.
File electronically through the Kansas Customer Service Center (KCSC) with Electronic Funds
Transfer (EFT) payment.
CONTACT INFORMATION:
Questions may be directed to the ABC Licensing Unit.
Phone: 785-296-7015
Email: KDOR_ABC.Licensing@KS.GOV
KANSAS SPECIAL ORDER SHIPPING
ANNUAL GALLONAGE TAX RETURN AND SALES REPORT INSTRUCTIONS
Alcoholic Beverage Control
109 SW 9
th
Street, 5
th
Floor
PO Box 3506
Phone: 785-296-7015
Fax: 785-296
-7185
www.ksrevenue.org/abcindex.html
Topeka KS 66601-3506
KANSAS SPECIAL ORDER SHIPPING ANNUAL
GALLONAGE TAX RETURN AND SALES REPORT
I have no sales to Kansas consumers this year.
DATE
YEAR: FEIN:
KANSAS SPECI
AL ORDER SHIPPING LICENSE NUMBER:
DBA NAME:
ADDRES
S:
CITY/STATE:
ZIP CODE:
CONTACT PERSON:
E-MAIL ADDRESS:
PRODUCT TYPE:
Fortified Wine
(14.1% ABV or more)
(FSOS)
CODE:
01
GALLONS: TAX RATE:
$0.75 / Gallon
TAX DUE:
$ X =
PRODUCT TYPE:
Light Wine
(14% ABV or less)
(LSOS)
CODE:
01
GALLONS: TAX RATE:
$0.30 / Gallon
TAX DUE:
$ X =
TOTAL GALLONAGE TAX DUE =
$
CODES:
01= Wine Shipped to Kansas Consumers
I declare under penalties of perjury that to the best of my knowledge and belief this is a true,
correct and complete return.
SIGNATURE
ABC-1040 (Rev.12/20)
click to sign
signature
click to edit
Alcoholic Beverage Control
109 SW 9
th
Street, 5
th
Floor
PO Box 3506
Phone: 785-296-7015
Fax: 785-296
-7185
www.ksrevenue.org/abcindex.html
Topeka KS 66601-3506
I have no shipments to Kansas consumers this year.
DATE
Date Code Shipped Shipped Total
Wine
LICENSE NUMBER:
KANSAS SPECIAL ORDER SHIPPING ANNUAL
GALLONAGE TAX RETURN AND SALES REPORT
YEAR: FEIN:
DBA Name:
E-MAIL ADDRESS:
CONTACT PERSON:
PHONE:
Shipment
Tracking Number
Customer Name
Address
City
Zip
Quantity
Size
Gallons Shipped:
Order
Fortified
Wine
Light
$
$
$
$
$
$
$
$
$
$
$
$
$
I declare under penalties of perjury that to the best of my knowledge and belief this is a true, correct and complete report.
SIGNATURE
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of
ABC-1040 (Rev. 12/20)
click to sign
signature
click to edit