Form Tt-105 - Wisconsin Distributor'S Tobacco Products Tax Return - Out-Of-State Permittees
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1
2Wisconsin Distributor’s Tobacco Products Tax Return – Out-of-State Permittees
Read the instructions on the reverse side before completing this return.
Wisconsin
Mail your return with payment to:
Permit Number
Wis. Department of Revenue
Legal Name
Month and Year (MM YYYY)
Box 93640
Milwaukee WI 53293-0640
DBA
Federal Employer ID Number
Questions or need more forms?
Address
PERMIT CANCELLATION
Call (608) 266-8970
Cancel my permit effective
E-mail: excise@revenue.wi.gov
City, State, Zip
Website:
(MM DD YYYY)
Check if there was a change to:
Name
Address
Business entity (FEIN)
SECTION 1 – All Tobacco Products Tax (excluding moist snuff and cigars)
1 Total taxable sales at manufacturers list price (Form TT-107, line 21) . . . . . .
1
50%
2 Tobacco products tax rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
3 Tobacco products tax amount due / (refund) (multiply line 1 by line 2) . . . . . . . . . . . . . . . . . . . . . . . . .
3
SECTION 2 – Moist Snuff Tax
4 Total weight in ounces of taxable moist snuff sales
(Form TT-107M, line 22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
$ 1.31
5 Moist snuff tax rate per ounce . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
6 Moist snuff tax (multiply line 4 by line 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
SECTION 3 – Cigar Tax
7 Total tax on cigars sales amount due / (refund) (Form TT-107C, line 20) . . . . . . . . . . . . . . . . . . . . . . .
7
SECTION 4 – Tax Reconciliation
8 Total tobacco products, moist snuff, and cigar tax due / (refund) (add lines 3, 6, and 7) . . . . . . . . . . .
8
9 Less tobacco products bad debt deduction (Form TT-117, column G, line 13) . . . . . . . . . . . . . . . . . . . .
9
10 Add tobacco products bad debt repayment (attach schedule and explanation) . . . . . . . . . . . . . . . . . . . 10
11 TOTAL AMOUNT DUE / (REFUND DUE) (line 8 minus line 9 plus line 10) . . . . . . . . . . . . . . . . . . . . . . 11
Check box if paying by electronic funds transfer (EFT)
DECLARATION I declare under penalties of law that I have examined this return and all attachments and to the best of my knowledge and belief,
it is true, correct and complete.
Signature of permittee (or authorized agent)
Preparer’s name (print or type)
Preparer’s phone number
Date
TT-105 (R. 1-08)
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