Form Et-59 - Dealer'S Monthly Report Of Unstamped Cigarettes Received In Ohio - 2001
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1ET-59
_________________
_____
*DEALER’S MONTHLY REPORT OF UNSTAMPED CIGARETTES RECEIVED IN OHIO DURING
20
(REV. 2/01)
(MONTH)
NAME ________________________________________________________________________________
OHIO TAX ACCOUNT NO. ______________________
ADDRESS ___________________________________________________________________ _______________________________________ __________ _____________________
(STREET)
(CITY)
(STATE)
(ZIP CODE)
NUMBER OF CIGARETTES
OTHER
DATE
LIGGETT &
BROWN &
RECEIVED
INVOICE NO.
MYERS
LORILLARD
PHILIP MORRIS
R. J. REYNOLDS
WILLIAMSON
MANUFACTURER
NO. OF CIG.
(000)
(000)
(000)
(000)
(000)
PAGE TOTAL
SUMMARY TOTAL
* This report must be completed and filed even if no cigarettes were received during the month. (See reverse side for instructions.)
PAGE ________ OF ________
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