Form Mt-203-W - Wholesale Dealer Of Tobacco Products Informational Return
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1MT-203-W
New York State Department of Taxation and Finance
Wholesale Dealer of Tobacco Products Informational Return
(11/10)
(See instructions, Form MT-203-W-I, for assistance.)
Employer identification number
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
A
B
C
D
E
Number of
Number of
Pounds of other
Ounces of snuff
Number of packs
Inventory information
individual snuff
individual cigars
tobacco products
containers of one
of little cigars
containers of less
ounce or more
than one ounce
1 Beginning inventory .................................................................................................
1.
2 Acquisitions during the month
2.
(from Form MT-203-W-A, lines 3, 9, and 15, column(s) A, B, C, D, and/or E)
3 Total quantity available for sale or other disposition
3.
....................
(add lines 1 and 2)
4 Total wholesale sales within New York State during the month
....................
4.
(from Form MT-203-W-T, lines 3, 9, and 15, column(s) A, B, C, D, and/or E)
5 Total transfers and wholesale sales outside of New York State during the month
............
5.
(from Form MT-203-W-T, lines 9, 21, 27, and 33, column(s) A, B, C, D, and/or E)
6 Total wholesale sales to Indian nations and tribes during the month .....................
6.
7 Total other dispositions
..................................................................
7.
(see instructions)
8 Total transfers, sales, and other dispositions
.........................
8.
(add lines 4 through 7)
9 Ending inventory
...............................................................
9.
(subtract line 8 from line 3)
10 Physical inventory ................................................................................................... 10.
11 Difference
................................................ 11.
(subtract line 10 from line 9; see instructions)
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
Taxpayer’s e-mail address
Telephone number
(
)
Mark an X if
Preparer’s signature
Telephone number
Date
Preparer’s SSN or PTIN
Mail your return and any related
self-
Paid
(
)
employed
schedules and attachments to:
preparer’s
Preparer’s firm name (or yours, if self-employed) Address
Firm’s EIN
use only
NYS TAX DEPARTMENT
Preparer’s e-mail address
Preparer’s NYTPRIN
TOBACCO PRODUCTS TAX
PO BOX 5420
ALBANY NY 12205-5420
Do you want to allow another person to discuss this return with the Tax Dept?
Yes
No
(see instructions)
(complete the following)
Third –
Designee’s name
Designee’s telephone number
Personal identification
party
(
)
number (PIN)
designee
Designee’s e-mail address
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