Montana Form Ct-205 - Cigarette Tax Page 3
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5Schedule A - Cigarette wholesaler purchasing recap
For the month of ________________________, 20 _____
Business name _____________________________________________ License Number _________________
•
In-state wholesaler must detail all purchases
•
Out-of-state wholesaler should only list products shipped into Montana
Number of unstamped cigarettes (include complimentary cigarettes)
(A + B + C +
(A)
Other cigarette manufacturer
D + E + F = G)
Brown &
(B)
(C)
(D)
(E)
(F)
Date
Invoice
Total sticks
Williamson
Ligget
Lorillard
Philip Morris
R.J. Reynolds
Manufacturer
Cigarette
Qty
Rec’d
No
(X1000)
(X1000)
(X1000)
(X1000)
(X1000)
(X1000)
name
brand name
(X1000)
Total this page – Total column G add values from this page only ..........................................................................................................................
Total all pages – Total all value from all pages, fill on last page only, total value on line 2, section 1 ................................................................
Page 3
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Parent category: Financial