Schedule C-1 - Tobacco Products Tax - Record Of Snuff Tobacco Products Exported Out Of Connecticut Or Sold To The Federal Government

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Department of Revenue Services
Schedule C-1
State of Connecticut
Excise/Public Services Taxes Subdivision
Tobacco Products Tax
25 Sigourney Street
Record of snuff tobacco products exported out of Connecticut or sold to the federal government
Hartford CT 06106
(Rev. 11/03)
Enter the total of Schedule C-1 on Line 2 of Schedule A-3, Tobacco Products Tax - Resident Distributor - Snuff Tobacco Products Activity Report .
Attach Schedule C-1 to Form OP-300, Tobacco Products Tax Return. Prepare a separate Schedule C-1 for each state of destination.
Name ___________________________________________________
Period Ending __________________
CT Tax Registration Number ________________________
State of Destination ______________
Invoice
Invoice
Weight each
Total Weight
Date
Number
Customer Name
Customer Address
State
ZIP Code
(in ounces)
City
Brand Name
Quantity
(Column 9 x 10)
Column 6
Column 7
Column 1
Column 4
Column 5
Column 8
Column 9
Column 10
Column 11
Column 2
Column 3
Report this amount on Line 2 of Schedule A-3
Total

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