Tobacco Use Tax Worksheet - Alabama Department Of Revenue

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TOB: USE
2/10
A
D
R
LABAMA
EPARTMENT OF
EVENUE
S
, U
& B
T
D
• T
T
S
ALES
SE
USINESS
AX
IVISION
OBACCO
AX
ECTION
RESET
P .O. Box 327556 • Montgomery, AL 36132-7556 • (334) 242-9627 •
Tobacco Use Tax Worksheet
_______________________, ________
FOR THE MONTH OF
(MONTH OF ACTIVITY)
(YEAR)
INDIVIDUAL’S NAME
FEIN / SSN
ADDRESS
PERMIT / REGISTRATION NUMBER
CITY
STATE
ZIP
TELEPHONE NUMBER
(
)
See Instructions and Schedule of Taxes on Reverse Side to Compute Tax.
1
2
3
CIGARETTES ONLY
OTP ONLY (CIGARS, LITTLE CIGARS, SMOKING TOBACCO OTHER THAN R-Y-O,
TAX RATE .02125 / STICK
R-Y-O, SNUFF, AND CHEWING TOBACCO. SEE INSTRUCTIONS.)
INVOICE
DATE
NAME AND ADDRESS FROM WHOM RECEIVED
4
5
6
7
8
9
10
NUMBER
RECEIVED
NO. OF SINGLE
TAX DUE
TYPE OF
NO. OF ITEMS OR
RATE OF
NO. OF
TAX DUE
STICKS
(COL. 4 X .02125)
PRODUCT
SIZE OF PKG.
TAX
PKGS.
11. Total Tax Due Each Product Type. If you receive a product type more than once in a month, add the total tax due for the month. Place total tax due by product type in the appropriate
box below and place that figure on line 11 of the Monthly State Tobacco Tax Return by Tobacco Distributors.
SMOKING TOBACCO
CIGARETTES
SNUFF
R-Y-O
CIGARS
LITTLE CIGARS
OTHER THAN R-Y-O
Attach this worksheet to the Monthly State Tobacco Tax Return by Tobacco Distributors.

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