STATE OF WEST VIRGINIA 
State Tax Department, Tax Account Administration Div
P.O. Box 1826
Charleston, WV 25327-1826

Name

Address                                                                                                   Account #:

City                                                            State                 Zip

                              LIQUOR/WINE DISTRIBUTION RETURN

Sales of wine and liquor are subject to both the 6% Consumers Sales and Service Tax and the 5% municipal tax. The Sales Tax 
is reported and paid on the WV/CST-200 Consumers Sales and Service Tax Return.

YOU MUST COMPLETE THE BACK OF THE RETURN FIRST.

Line 1 - Enter total from Columns 3, 4 & 5 from back of return.
Line 2 - Multiply column 1 of line 1 from front of return (total wine sales) by 5% (round up to the next whole cent).
Line 3 - Multiply column 2 of line 1 from front of return (total liquor sales) by 5% (round up to the next whole cent).
Line 4 - Multiply column 3 of line 1 from front of return (total sales to private clubs) by 5% (round up to the next whole cent).
Line 5 - Add lines 2, 3 and 4.

PLEASE NOTE:  
THIS RETURN MUST BE COMPLETED AND RETURNED WITH REMITTANCE WHICH COVERS THE PERIOD
IN WHICH LIQUOR AND/OR  WINE SALES WERE TRANSACTED.
EACH LOCATION MUST BE LISTED SEPARATELY.
IF ADDITIONAL SPACES ARE REQUIRED, USE AN ATTACHMENT IN THE SAME FORMAT AS THIS RETURN.

Taxpayers required to file electronically will no longer receive returns for the tax types subject to the mandatory requirement 
by mail.  Please visit www.wvtax.gov for additional information.

        MAKE CHECK PAYABLE TO:                                                           MAIL TO :  WEST VIRGINIA STATE TAX DEPARTMENT
WEST VIRGINIA STATE TAX DEPARTMENT                                                                      Tax Account Administration Div
FOR ASSISTANCE CALL:  (304) 558-3333                                                                                     P.O. Box 1826
        TOLL FREE:  (800) 982-8297                                                                       Charleston, WV 25327-1826

        FOR PERIOD ENDED                                                                 Column 1             Column 2                Column 3
        DUE DATE                                                                         Total Wine Sales Total Liquor Sales          Total Sales to Private
                                                                                                                                      Clubs
        1. Total lines for each sales column
        2. Municipal tax - wine sales (line 1, column 1 X 5% - round up to the next whole cent)
        3. Municipal tax - liquor sales (line 1, column 2 X 5% - round up to the next whole cent)
        4. Municipal tax - private club sales (line 1, column 3 X 5% - round up to the next whole cent)
        5. Total due (add lines 2 through 4)

           SIGNATURE OF TAXPAYER OR PREPARER                                                              DATE
                                                                                                                                      CST270
                                                                                                                                      rtL051 v.3-Web

                                                                  PERIOD ENDED: 
  Column 1          Column 2 Column 3                             Column 4                Column 5
  Business Location DO NOT   Total Income from                    Total Income from       Total Income from
                    WRITE IN Wine Sales                           Liquor Sales            Wine and Liquor
                    THIS
                    COLUMN
                             (Do not include wine                 (Do not include liquor  Sales to
                             sales to private clubs)              sales to private clubs)  Private Clubs
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30

  Column 1 - Each store location is listed separately as shown on your license. If you discontinue sales at any 
  location, draw a single line through that location and enter the date of discontinuance to the right of the store 
  location. If you add a new location, print the name of the city (or county, if the business location is more 
  than one mile outside corporate city limits) in which the business is located on the next blank line.

  Column 2 - Do not write in column 2; the Department uses this column to encode the city and/or county to 
  receive any municipal tax collected from sales at that location.

  Column 3 - Enter your total wine sales for each location. Do not include any sales to private clubs.

  Column 4 - Enter your total liquor sales for each location. Do not include any sales to private clubs.

  Column 5 - Enter your total wine and liquor sales to private clubs. Do not include any tax collected.