Form 04-523 - Cigarette And Tobacco Products Tax Supporting Schedule Of Transactions
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1Cigarette and Tobacco Products Tax
Supporting Schedule of Transactions
License Number
Name of Licensee
Federal EIN or SSN
Period Ending (Month/Year)
This is a supporting schedule for Alaska Cigarette and Tobacco Products Monthly Tax Return Form 04-522. Use a separate
schedule for each type of transaction that applies to your business for the month for which you are making this return. Use
this schedule only for transactions pertaining to cigarettes and other tobacco products manufactured, imported, acquired or
sold after September 30, 1997. Use additional pages as necessary.
Check one:
A. Cigarettes and tobacco products manufactured, imported, acquired or sold
B. Credit for military sales
C. Credit for Indian sales
D. Other credits - unsaleable or destroyed cigarettes and tobacco products
Invoice
Name of Supplier
Invoice
Number of
Wholesale Price of
Date
or Purchaser
Number
Cigarettes
Other Tobacco Products
Total from attached pages
Total .........................................................................................…………………………………..
Page ________of________
Form 04-523 (Revised 9/97; effective for tax periods beginning after 9/30/97)
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