MT-203-W-A
New York State Department of Taxation and Finance
Acquisitions of Tobacco Products
(7/08)
Read Form MT-203-W-I, Instructions for Form MT-203-W, before completing. Keep a copy of this completed form for your records.
Legal name
Employer identification number (EIN)
Month/year
A
B
C
D
EIN
Name and address of supplier
Cigars
Snuff containers of less than one ounce
Snuff containers of one ounce or more
Other tobacco products
of supplier
No. of individual
Purchase price
Ounces of snuff
Purchase price
No. of individual
Purchase price
Pounds of tobacco
Purchase price
containers
cigars
A
B
C
D
E
F
G
H
I
1 Total acquisitions from this sheet
2 Total acquisitions from additional attached sheet(s), if any
3 Total acquisitions
(add lines 1 and 2; enter here and on
Form MT-203-W, line 2)
4 Total purchase price from this sheet
5 Total purchase price from additional attached sheet(s),
if any
6 Total purchase price
(add lines 4 and 5)