Arizona Form 800-25 - Cigarette Distributor'S Monthly Report - 1998
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4ARIZONA FORM
Luxury Tax
Arizona Department of Revenue
800 - 25
Tobacco Tax Section
1600 W Monroe, Site Code 603
Phoenix AZ 85007
Cigarette Distributor's Monthly Report
For the Month of __________________________ 19 __________
This return must be filed with the Department of Revenue not later than the 20th day of the 1st
month following the month for which this return is made.
Licensed distributor - name
Tobacco license no.
Taxpayer ID (EIN or SSN )
Address - mailing
Address - business location
City
State
ZIP code
City
State
ZIP code
Read Instructions Beginning on Page 4
Cigarette Inventory (Unstamped)
Packages of 25
1. Beginning inventory - Unstamped packages .....................................................................................
2. Additions: Received during month (Schedule A1-A4 and Schedule E) .............................................
3. Total unstamped packages to account for .........................................................................................
4. Deductions:
a. Unstamped product exported from state (Schedule C) ................................................................
b. Stamped other states (Stamped inventory below or Schedule C) ...............................................
c. Ending inventory - unstamped packages ......................................................................................
5. Total deductions (4a through 4c) .......................................................................................................
6. Total packages required to be Arizona stamped ...............................................................................
Stamp Inventory (Arizona only)
Blue ($.725)
Red ($.50)
Green (Tax Free)
Total
7. Beginning inventory - stamps on hand ...............................
8. Stamps purchased during month .......................................
9. Total stamps available..........................................................
10. Deductions
a. Stamps spoiled ..............................................................
b. Ending inventory - stamps on hand ...............................
11. Total deductions (10a plus 10b) ..........................................
12. Total stamps affixed during month ......................................
If line 6 does not equal line 12 total, attach explanation of difference to the back of this report.
Stamped Cigarette Inventory
Arizona Blue
Arizona Red
Arizona Green
Other States
($.725)
($.50)
(Tax Free)
13. Beginning inventory - packs on hand ..................................
14. Adjustments:
a. added into inventory ......................................................
b. taken out of inventory ....................................................
15. Total adjustments (14a minus 14b) .....................................
16. Ending inventory .................................................................
Declaration of preparer (other than taxpayer) is based on all information of
I have read this claim and any attachments with it. Under penalties of perjury, I
which preparer has any knowledge.
declare that to the best of my knowledge and belief, they are correct and complete.
Preparer's Signature
Taxpayer's/Authorized Agent's Signature
Preparer's TIN
Date
Title
Date
ADOR 20-2042 (9/98)
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