Form Cg-89 - Wholesale Dealer Of Cigarettes Informational Return
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2CG-89
New York State Department of Taxation and Finance
Wholesale Dealer of Cigarettes
(7/10)
Informational Return
Employer identification number (EIN)
Legal name
Quarterly period ending
(corporation, partnership, or individual name)
(mm/dd/yy)
Trade name
Mark an X in all that apply
(see instructions)
No business this quarter
Street address
Cancel license
City, state, and ZIP code
Business telephone number
(
)
Amended return
Sales and Transfers —
List all sales and transfers during the previous quarter
(see instructions; attach additional sheets if necessary).
A
B
C
D
E
F
G
H
Name and address of customer
EIN of customer
Date of
Number of
Sales
Sales
Sales
Total
transaction
cartons
price of
price of
price of
( E + F + G)
sold
cigarettes
tobacco
non-cigarette
and/or
sold and/or
products sold
items sold and/or
transferred
transferred to
and/or
transferred to
to customers
customers
transferred
customers
to customers
Total from additional sheet(s) attached ........................................................................................................
Total sales and transfers ...............................................................................................................................
Certification: I certify that the information on this return and any attachments is to the best of my knowledge and belief true, correct, and complete.
Date
Authorized signature
Official title
Telephone number
(
)
Taxpayer’s e-mail address
Mark an X if
Preparer’s signature
Telephone number
Date
Preparer’s SSN or PTIN
self-
Paid
(
)
employed
preparer’s
Preparer’s firm name (or yours, if self-employed) Address
Preparer’s EIN
use only
Preparer’s e-mail address
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Parent category: Financial