Monthly Report By Resident Wholesale Dealers In Cigarette Products - Alabama Department Of Revenue

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TOB: T-WHSLE

12/10

LABAMA

EPARTMENT OF

EVENUE

Reset

, U

& B

ALES

USINESS

IVISION

Over _________________

Short ________________

OBACCO

ECTION

Checked By ___________

P.O. Box 327555 • Montgomery, AL 36132-7555 • (334) 242-9627

Monthly Report by Resident Wholesale Dealers in Cigarette Products

For the Month of _________________________, _________

NAME

FEIN OR SOCIAL SECURITY NUMBER

ADDRESS

PERMIT NUMBER

CITY

STATE

ZIP

TELEPHONE NUMBER

(

)

–

This report must be filed with the Alabama Department of Revenue between the first and twentieth of each month for all cigarette products

and Alabama state stamps handled during the preceding month.

Reports must be made in duplicate. Original must be mailed to the above address and the copy, along with detailed documentation, retained

in your files subject to audit and inspection by the Alabama Department of Revenue.

PART I – CIGARETTES

(b)

(a)

TAX VALUE

NUMBER OF CIGARETTES

(Col. a x $0.02125)

1. Beginning inventory of unstamped cigarettes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2. Cigarettes purchased during month (Complete Part II) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3. TOTAL CIGARETTES TO ACCOUNT FOR (add lines 1 and 2) . . . . . . . . . . . . . . . . . . . . . . .

Less:

4. Unstamped sales to Alabama National Guard Units (Complete Part III) . . . . . . . . . . . . . . . . .

5. Unstamped sales to U.S. Government (Complete Part IV) . . . . . . . . . . . . . . . . . . . . . . . . . . .

6. Unstamped sales to Federally Recognized Indian Reservations (Complete Part V) . . . . . . . .

7. Unstamped sales into other states (attach Schedule C). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8. Other states’ stamped cigarettes returned to the manufacturer . . . . . . . . . . . . . . . . . . . . . . . .

9. Ending inventory of unstamped cigarettes (Include unstamped cigarettes and other

states’ stamped cigarettes including those held for shipment back to the manufacturer.) . . . .

10. TOTAL (add lines 4 through 9). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11. TOTAL CIGARETTES STAMPED (line 3 less line 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Complete Schedule D (form TOB: SCH D)

INVOICE DATE

INVOICE NUMBER

STAMP VALUE

12. STATE CIGARETTE STAMP PURCHASES:

13. TOTAL STATE CIGARETTE STAMP PURCHASES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

14. Beginning inventory of state cigarette stamps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15. TOTAL STATE CIGARETTE STAMPS AVAILABLE (add lines 13 and 14). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16. Ending inventory of state cigarette stamps. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

17. State cigarette stamps used (line 15 less line 16) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18. DIFFERENCE (line 11 column (b) less line 17) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Under penalties of perjury, I hereby certify that this report and the statements contained herein are true and correct.

SIGNATURE

TITLE

DATE