Lcmw 811 Form – Fill Out and Use This PDF

The LCMW-811 form is a critical document for businesses that navigate the complexities of tax claims related to beer, mixed spirit drinks, or wine in Michigan. Managed by the Michigan Department of Licensing and Regulatory Affairs Liquor Control Commission, it facilitates the recovery of taxes for licensees under specific conditions, such as tax-exempt sales or uninsured loss of taxed products. Understanding and accurately completing this form is paramount for businesses seeking refunds or credits for taxes paid on beverages that ultimately were not sold due to specified reasons. To begin filling out your LCMW-811 form, click the button below.

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Lcmw 811 Form PDF Details

The LCMW 811 form, provided by the Michigan Department of Licensing and Regulatory Affairs Liquor Control Commission (MLCC), serves as an essential document for licensees seeking a refund or credit for beer, mixed spirit drink, or wine taxes. Located in Lansing, Michigan, the MLCC oversees the administration of liquor licenses and the regulation of the state's liquor industry to ensure compliance with the Liquor Control Act. The LCMW 811 form caters to various situations where a claim may be warranted, including tax-exempt sales to the military, shipments intended for resale or consumption outside Michigan, adjustments due to shipping or billing errors, overage products not saleable on installations or Indian reservations, and uninsured losses of taxed products. To file a claim, licensees must provide detailed information about their business and the specific taxes for which they are seeking recovery, choosing from separate sections tailored to their circumstances. It's emphasized that any false or fraudulent statement can lead to fines or license penalties, and the filing is subject to stringent verification and investigative steps by the commission to ensure the legitimacy and accuracy of claims. Additionally, specific questions related to uninsured losses must be addressed to gauge eligibility for tax recovery. With provisions for crediting tax-paying licenses or refunding those not directly paying these taxes upon approval, the form underscores the MLCC’s commitment to fairness and the support of businesses within the regulatory framework. Moreover, it highlights the necessity for claimants to demonstrate their tax payment, the occurrence and extent of their loss, and compliance with the Liquid Control Act's provisions. The form, designed with sections for detailed itemization, helps streamline the process, ensuring clarity and precision in claim submissions.

Question	Answer
Form Name	Lcmw 811 Form
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	LCMW811_0109_26 4365_7 lcmw 811 2014-2019 form

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Michigan Department of Licensing and Regulatory Affairs

Liquor Control Commission (MLCC)

Constitution Hall - 525 W. Allegan, Lansing, MI 48933

Mailing Address: PO Box 30005, Lansing, MI 48909

Toll Free 866-813-0011 • www.michigan.gov/lcc

CLAIM FOR RECOVERY OF BEER, MIXED SPIRIT DRINK OR WINE TAXES

_________________________________________________________________________________________________

IMPORTANT NOTICE

•Any person who makes a false or fraudulent statement to the Commission to induce the Commission to act or to refrain from acting shall be guilty of a violation of the Liquor Control Act and subject to a fine, suspension or revocation of the license.

•Filing of this claim is voluntary. However, failure to file this claim will result in no action being taken by the Commission.

•Please submit separate claims for Beer taxes, Mixed Spirit Drink taxes, and for Wine taxes.

•Upon approval of this claim, credits are issued to tax-paying licenses; refunds are issued to licensees who do not pay Beer, Mixed Spirit Drink, or Wine taxes.

1. Name and Address of Licensee

2.Business Telephone

3.License Type and Number

4.Check only ONE

Submit separate claims for beer, mixed spirit drink or wine.

Claim for Beer Tax Claim for Spirit Drink Tax Claim for Wine Tax

5. Check type of claim and follow instructions shown below for each.

A.	TAX EXEMPT SALE TO MILITARY	D.	OVERAGED BEER, MIXED SPIRIT DRINK OR WINE -
	INSTALLATION OR INDIAN RESERVATION		NOT SALEABLE
	• Claims must be made within 3 months of sale.	•	Itemize overaged product on the back of this form.
	• Itemize shipments on the back of this form.	•	Product for which a claim is submitted shall be destroyed by prior
	• Attach applicable sales invoices.		Commission Order or removed from Michigan.
	• Attach applicable sales invoices.

B. TAX EXEMPT SHIPMENT FOR RESALE &		E.	UNINSURED LOSS OF BEER, MIXED SPIRIT DRINK, OR
	CONSUMPTION OUTSIDE MICHIGAN		WINE TAXES PAID
	• Itemize shipments on the back of this form.	•	Claims must be made within 3 months of the date of occurrence
	• Attach applicable invoices which show original		or delivery.
	• Attach applicable invoices which show original
	tax payment and out-of-state shipment.	•	Claims for theft of product will not be processed.
	• A credit or refund is available only to the person	•	Itemize losses on the back of this form.
	who paid the tax.	•	It is the responsibility of the claimant to prove that a loss occurred
		•
C.	ADJUSTMENT OF BEER, MIXED SPIRIT		and the amount of the loss. All claims will be investigated.
C.	ADJUSTMENT OF BEER, MIXED SPIRIT
	DRINK, OR WINE TAXES DUE TO SHIPPING	•	Product for which a claim is submitted shall be destroyed by prior
	OR BILLING ERRORS	•
	OR BILLING ERRORS		Commission Order or removed from Michigan.
			Commission Order or removed from Michigan.

•Itemize shipments on the back of this form.

•Attach clearly marked billing/credit invoices which show errors and corrections.

6.If you checked UNINSURED LOSS OF BEER, MIXED SPIRIT DRINK, OR WINE TAXES PAID, Section E above, you must also answer these questions:

• Was the loss or damage incurred the result of any action by you or your agent?

Yes

•Have you made or will you make, any other claim under any other law or to any insurance agency for recovery of these taxes? Yes No


•	Was the product in your possession for resale purposes?					Yes	No
•	Describe loss	Fire	Flood	Casualty	Other (explain) __________________________________________

•Date of loss ______ / ________/ ________ ? Location of loss _____________________________________________

I swear that all of the information, including the itemized description on the back of this Claim (and any subsequent pages) is true and is submitted in order to receive a refund or credit for taxes paid.

Signature ________________________________________ Title ___________________________________ Date _______________

LCMW-811 (Rev. 06/14)

Authority: MCL 436.1301, 436.1409

Completion: Mandatory

Penalty: No Credit

LARA is an equal opportunity employer/program.

Auxiliary aids, services and other reasonable accommodations are available upon request to individuals with disabilities.

6.ITEMIZED DESCRIPTION This page may be photocopied if necessary. Please attach any copies to the back of this claim form. You may also attach a summary report which contains the same information.

		BOTTLE		NUMBER OF	TOTAL LITERS OF MIXED		TOTAL	INVOICE	INVOICE
	BRAND NAME OF PRODUCT	BOTTLE		NUMBER OF	SPIRIT DRINK OR WINE OR		TOTAL	INVOICE	INVOICE
	BRAND NAME OF PRODUCT		SIZE	BOTTLES	SPIRIT DRINK OR WINE OR		TAX PAID	NUMBER	DATE
			SIZE	BOTTLES	BARRELS OF BEER		TAX PAID	NUMBER	DATE
					BARRELS OF BEER

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		CALCULATE TOTALS:
	For MLCC Use Only
	For MLCC Use Only
	TOTAL TAX PAID FOR THIS CLAIM		CREDIT ISSUED			APPROVED BY
	BEER:
	WINE:
	WINE:		REFUND ISSUED			DATE
	MIXED SPIRIT DRINK:

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This form will require particular details to be entered, therefore you should definitely take the time to provide what is expected:

1. You will need to complete the Lcmw 811 Form accurately, hence be careful while working with the sections containing these particular blank fields:

2. Just after the previous part is done, go to enter the suitable information in these - If you checked UNINSURED LOSS OF, Was the loss or damage incurred, Yes No, Was the product in your, I swear that all of the, Signature Title Date, LCMW Rev Authority MCL, and LARA is an equal opportunity.

I swear that all of the, Yes No, and If you checked UNINSURED LOSS OF inside Lcmw 811 Form

3. Within this part, look at SIZE, BOTTLES, BARRELS OF BEER, TOTAL TAX PAID, INVOICE NUMBER, and DATE. Each one of these need to be completed with highest accuracy.

Lcmw 811 Form conclusion process explained (step 3)

Always be extremely careful when filling in INVOICE NUMBER and TOTAL TAX PAID, since this is the section in which a lot of people make some mistakes.

4. Filling out is crucial in the next step - ensure that you take your time and fill in each blank area!

this field, next field, and other fields in Lcmw 811 Form

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Lcmw 811 Form – Fill Out and Use This PDF

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