AZ FORM 819NR
Instructions
List each invoice on a separate line with the name and address of
(i.e., round .1 oz. - .4 oz. down to 0 oz., round .5 oz. - .9 oz. up to
who the product was sold to, the date and number of the invoice,
1 oz.). Enter totals here.
and the total number of items or total number of ounces shipped,
Line 8: Calculate the number of items and number of ounces from
whichever is applicable.
Do not round ounces of individual
line 7 that were sold tax free. Enter totals here.
packages.
Line 9: Multiply the totals on line 8 by the total tax rate. Enter
Sum the total number of items shipped and the total number of
amounts here.
ounces shipped from all invoices. If necessary, round the total
Line 10: Add amounts from line 9. Enter total here.
number of ounces received from all invoices to the whole ounce.
Line 11: Add lines 6 and 10. Enter total here and on page 1,
Round partial ounces of cavendish, plug, or twist up to the next
line 2.
highest ounce (i.e., round .1 oz. - .9 oz. up to 1 oz.). Round partial
ounces of smoking tobacco, snuff, fi ne cut chewing, etc. to the
NOTE: Form 819NR does not contain
nearest ounce (i.e., round .1 oz. - .4 oz. down to 0 oz., round .5 oz.
Schedule A-1 or Schedule A-2.
- .9 oz. up to 1 oz.).
Multiply the total number of items and the total number of ounces
Special Defi nitions for Schedule A-3 and
shipped during the month by the appropriate tax rate to calculate
Schedule A-4:
“Net Taxes this Month.”
“Cigarette” means any product that contains nicotine, is intended
Sum the “Net Taxes This Month” to calculate the “Total Taxes This
to be burned or heated under ordinary conditions of use, and
Month”. Enter this amount on page 1, line 1.
consists of or contains: (1) any roll of tobacco wrapped in paper
Retailers whose registration numbers end in “-1” are either owned
or in any substance not containing tobacco; or (2) tobacco, in
by an Indian tribe, a tribal enterprise, or an enrolled member of
any form, that is functional in the product, which, because of its
the tribe. These retailers should collect both the §42-3251 and
appearance, the type of tobacco used in the fi ller, or its packaging
§42-3251.01 tax rates when selling to a non-enrolled member of
and labeling, is likely to be offered to, or purchased by, consumers
the tribe.
as a cigarette; or (3) any roll of tobacco wrapped in any substance
Retailers whose registration numbers end in “-2” are licensed
containing tobacco which, because of its appearance, the type of
Indian traders. These retailers should collect the §42-3052, the
tobacco used in the fi ller, or its packaging and labeling, is likely to
§42-3251, and the §42-3251.01 tax rates when selling to a non-
be offered to, or purchased by, consumers as a cigarette described
enrolled member of the tribe.
in clause (1) of this defi nition. The term “cigarette” includes “roll-
your-own” tobacco as defi ned below.
For “-1” retailers, enter the registration number, name, invoice
date and number, and the total number of items or total number of
“Roll-your-own” tobacco means any tobacco which, because of its
ounces sold, whichever is applicable. Do not round off ounces of
appearance, type, packaging, or labeling is suitable for use and
individual packages.
likely to be offered to, or purchased by, consumers as tobacco for
making cigarettes.
Line 1: Sum the total number of items sold and the total number of
ounces sold from all invoices. If necessary, round the total number
“Brand family” means all styles of cigarettes sold under the same
of ounces sold from all invoices to the whole ounce. Round partial
trademark and differentiated from one another by means of
ounces of cavendish, plug, or twist up to the next highest ounce
additional modifi ers or descriptors, including, but not limited to,
(i.e., round .1 oz. - .9 oz. up to 1 oz.). Round partial ounces of
“menthol”, “lights”, “kings”, and “100s”, and includes any brand
smoking tobacco, snuff, fi ne cut chewing, etc. to the nearest ounce
name (alone or in conjunction with any other word), trademark,
(i.e., round .1 oz. - .4 oz. down to 0 oz., round .5 oz. - .9 oz. up to
logo, symbol, motto, selling message, recognizable pattern
1 oz.). Enter totals here.
of colors or any other indicia of product identifi cation identical
or similar to, or identifi able with, a previously known brand of
Line 2: Calculate the number of items and number of ounces from
cigarettes.
line 1 that were sold tax free. Enter totals here.
“Master Settlement Agreement” means the settlement agreement
Line 3: Multiply the totals on line 2 by the total tax rates. Enter
(and related documents) entered into on November 23, 1998
amounts here.
by the State and leading United States tobacco product
Line 4: Calculate the number of items and number of ounces from
manufacturers.
A copy of the Master Settlement Agreement
line 1 that were sold for which both the §42-3251 and the §42-
may be found at the web site of National Association of Attorneys
3251.01 tax rates were collected. Enter totals here.
General,
Line 5: Multiply the totals on line 4 by the §42-3052 tax rates.
“Tobacco product manufacturer” means an entity that directly (and
Enter amounts here.
not exclusively through any affi liate):
Line 6: Add amounts from lines 3 and 5. Enter total here.
1) Manufactures cigarettes anywhere that such manufacturer
For “-2” retailers, enter the registration number, name, invoice
intends to be sold in the United States, including cigarettes
date and number, and the total number of items or total number of
intended to be sold in the United States through an importer
ounces sold, whichever is applicable. Do not round off ounces of
(except where such importer is an original participating
individual packages.
manufacturer (as that term is defi ned in the Master
Line 7: Sum the total number of items sold and the total number of
Settlement Agreement) that will be responsible for the
payments under the Master Settlement Agreement with
ounces sold from all invoices. If necessary, round the total number
respect to such cigarettes as a result of the provisions of
of ounces sold from all invoices to the whole ounce. Round partial
subsection II(MM) of the Master Settlement Agreement and
ounces of cavendish, plug, or twist up to the next highest ounce
that pays the taxes specifi ed in subsection II(Z) of the Master
(i.e., round .1 oz. - .9 oz. up to 1 oz.). Round partial ounces of
Settlement Agreement, and provided that the manufacturer
smoking tobacco, snuff, fi ne cut chewing, etc. to the nearest ounce
Page 14 of 17
ADOR 14-5322 (8/05)