Cigarette Floor Stock Tax Return Form - 2005

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Cigarette Floor Stock
Washington State
07
Department of Revenue
Tax Return
Special Programs Division
05
PO Box 47464
Olympia WA 98504-7476
Instructions
1.
Based on your cigarette inventory as of June 30, 2005, enter the number of packs of stamped cigarettes and unaffixed
stamps in stock on lines 1 through 5.
2.
If paying for more than one location, list all locations and their inventory on a separate sheet and attach to this return. Please
enter the sum of all locations on this original return.
3.
Multiply the inventory number by the increased tax amount and enter the result in the right hand column.
4.
Add lines 1-5 and enter the sum on line 6.
5.
This return is due by August 1, 2005. If you are filing the return after this date, you owe a penalty. See penalty information
below. Enter penalty on line 7.
6.
Add lines 6 and 7 and enter that amount on line 8. Mail this form with your payment in the enclosed envelope. Do not mail
with your excise tax return as processing errors may occur.
7.
If you have any questions, please contact the Department of Revenue's Telephone Information Center at (360) 705-6715 or
1-800-647-7706.
Important:
This return is subject to future audit by the Department of Revenue. Please keep a copy of your cigarette
inventory records.
If the tax due is not received on or before August 1, 2005 penalty is assessed as follows:
5% after August 1, 2005
15% after August 31, 2005
25% after September 30, 2005
Minimum Penalty Amount is $5.00
RECORD RESULTS OF INVENTORIES BELOW (Shown in packages, not cartons)
1.
Number of packages containing 1 cigarette
x $ .03 =
$
.
2.
Number of packages containing 20 cigarettes
x $ .60 =
$
.
3.
Number of packages containing 25 cigarettes
x $ .75 =
$
.
DISTRIBUTORS ONLY
4.
Number of unaffixed fuson stamps for packs of 20 cigarettes
x $ .60 =
$
.
DISTRIBUTORS ONLY
5.
Number of unaffixed fuson stamps for packs of 25 cigarettes
x $ .75 =
$
.
6.
Total Tax Due (add lines 1-5)
$
.
Signature:
$
.
7. Penalty
Phone No:
Date:
8. This Amount Owed
$
.
Name & Address of Firm (if changed):
THIS RETURN IS DUE AUGUST 1, 2005
For tax assistance visit or call 1-800-647-7706. To inquire about the availability of this document in an alternate format for the
visually impaired, please call (360) 705-6715. Teletype (TTY) users may call 1-800-451-7985.
Please RETURN THIS ORIGINAL COPY to the Department of Revenue in the enclosed envelope.
REV 82 2085 (05/12/05)

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