Schedule C Template - Record Of Tobacco Products (Excluding Snuff Tobacco Products) Exported Out Of Connecticut

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Department of Revenue Services
State of Connecticut
Schedule C
Excise/Public Services Taxes Subdivision
25 Sigourney Street
Hartford CT 06106
Tobacco Products Tax - Resident Distributor
(Rev. 05/03)
Record of tobacco products (excluding snuff tobacco products) exported out of Connecticut
Name __________________________________________________ Period Ending ________________________________________
CT Tax Registration Number ________________________________ State of Destination ____________________________________
Enter the total of Schedule C on Line 4 of Form OP-300, Tobacco Products Tax Return . Attach Schedule C to the return.
Wholesale Sales Price means: In the case of a distributor that is the manufacturer of the tobacco products, the price set for these products
or, if no price has been set, the wholesale value of these products, and, in the case of a distributor that is not the manufacturer of the
tobacco products, the price at which the distributor purchased the products.
Invoice
Invoice
Wholesale
Date
Number
Customer Name
City
State
ZIP Code
Sales Price
Total

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