Form Tob-101 - Delivery Sales Of Cigarette/other Tobacco Products To Persons In Indiana

Download a blank fillable Form Tob-101 - Delivery Sales Of Cigarette/other Tobacco Products To Persons In Indiana in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form Tob-101 - Delivery Sales Of Cigarette/other Tobacco Products To Persons In Indiana with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

Indiana Department of Revenue

Mail To: Indiana Department of Revenue

TOB-101

P.O. Box 901

Delivery Sales of Cigarette/Other Tobacco Products

Indianapolis, IN 46206-0901

SF# 51418

to Persons in Indiana

(R2/05-07)

Delivery Sales of cigarettes/other tobacco products into the State of Indiana for the month ending __________/20________.

Due Date: 10th day of the calendar month following the month in which Cigarettes/Other Tobacco Products were shipped into the State of Indiana and where the appropriate

tobacco taxes were not collected from the purchaser.

Merchants Name

Federal FEIN or SSN

Mailing Address

Telephone Number

City

State

Zip Code

E-Mail Address

Contact Person

Title

Contact Telephone Number

Attach additional sheets as needed.

Invoice Date

Invoice

Purchaser’s

Product

Cigarette

Other Tobacco Products

Number

Name

Address

Brand

Number of

Sales Price

Wholesale Price

Sales Price

Cigarettes

Note: Your own form may be attached if it contains all the necessary information. (For example, a Computer Generated Report)

Delivery Sale - A delivery sale is deﬁ ned in IC 24-3-5-1 as: A transaction for the purchase of tobacco products in which an offer to purchase tobacco products is made:

(1) electronically using a computer network (as deﬁ ned in IC 35-43-2-3); (2) by mail; or (3) by telephone; and acceptance of the offer results in delivery of

tobacco products to a named individual at a designated address.

For questions related to this form, call (317) 615-2557