Form Rc-6-A - Out-Of-State Cigarette Revenue Return - 2000

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Illinois Department of Revenue
RC-6-A
Out-of-State Cigarette Revenue Return
Attach all necessary schedules.
E S NS DP CA ___/___/___
Do not write above this line.
Step 1: Identify your business
1
2
IBT no.__________________________________________________________
For what tax period are you filing this return?
Illinois business tax
___ ___/___ ___ ___ ___
Month
Year
U –
License no._______________________________________________________
3
Is this an amended return?
yes
no
Business name____________________________________________________
4
Is this a final return?
yes
no
Address__________________________________________________________
A “final” return indicates that you no longer
Number and street
intend to conduct business.
__________________________________________________________________
City
State
ZIP
5
Check here if your address has changed
or you have made changes to the label.
Step 2: Report your cigarette stock
Number of cigarettes
,
,
,
6
6
Write your total purchase of Illinois stamped cigarettes (from Schedule CC).
______
_________
_________
_________
,
,
,
7
7
Write the total of Illinois stamped cigarettes returned to manufacturers
______
_________
_________
_________
(from Schedule CD).
,
,
,
8
8
Write the total of other deductions (from Schedule CH).
______
_________
_________
_________
,
,
,
9
9
Write the total of unstamped and non-Illinois stamped cigarettes shipped into
______
_________
_________
_________
Illinois (from Schedule CK).
,
,
,
10
10
Write the net total of Illinois stamped cigarettes shipped into Illinois
______
_________
_________
_________
(from Schedule CL).
11
11 $
Multiply Line 10 by 29 mills (.029). This is the total value of stamps affixed to
________________________|_________
cigarettes that you sold.
Step 3: Report your cigarette revenue stamp usage
Dollar value
12
12 $
Write the total value of all cigarette revenue stamps on hand at the beginning
________________________|_________
of the month.
13
13 $
Write the total value of cigarette revenue stamps purchased during the month
________________________|_________
(from Schedule CF).
14
14 $
Multiply Step 2, Line 6, by 29 mills (.029). This is the total value of cigarette
________________________|_________
revenue stamps affixed when purchased.
15
15 $
Add Lines 12, 13, and 14. This is the total value of stamps on hand at the
________________________|_________
beginning of the month plus any purchases made during the month.
16
16 $
Write the total value of unaffixed cigarette revenue stamps on hand at the
________________________|_________
end of the month (from Schedule CF).
17
17 $
Write the total value of affixed cigarette revenue stamps on hand at the
________________________|_________
end of the month (from Schedule CF).
18
18 $
Add Lines 16 and 17. This is the total value of all cigarette stamps on hand.
________________________|_________
19
19 $
Subtract Line 18 from Line 15. This is the total value of affixed cigarette
________________________|_________
revenue stamps sold during the month.
Step 4: Sign below
Under penalties of perjury, I state that I have examined this return and all accompanying schedules and, to the best of my knowledge, it is
true, correct, and complete. I also state that such information is taken from the books and records of the business for which this return is filed.
_________________________________________________________________________(____)________________________
Preparer's signature
Title
Telephone number
Date
Do not send any payment with this return. Please make a copy for your files.
This form is authorized by the Cigarette Tax Act. Disclosure of this information is REQUIRED. Failure to provide information
RC-6-A front (R-12/00)
could result in a penalty. This form has been approved by the Forms Management Center.
IL-492-3153

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