TT-13
MONTHLY REPORT OF CIGARETTE STAMPING AGENT
Virginia Department of Taxation
Name
Month/Year
Mail To:
Trading As
Permit Number
Department of Taxation
P. O. Box 715
Number and Street
Richmond, VA 23218-0715
City or Town, State, ZIP Code
Packs of 20
Packs of 25
SECTION I — Cigarette Reconciliation
1. Balance of all unstamped cigarette packs on hand first day of month
+
+
2. Total unstamped cigarette packs received during month (from Schedule A)
=
=
3. Total unstamped cigarette packs available (add lines 1 and 2)
-
-
4. Total unstamped cigarette packs sold during month (from Schedule C)
5. Total cigarette packs stampable during month (line 3 minus line 4)
=
=
-
-
6. Total Virginia stamped cigarette packs during month (from Schedule D)
-
-
7. Unstamped cigarette packs returned to manufacturer
=
=
8. Balance of all unstamped cigarette packs on hand last day of month (line 5 minus lines 6 and 7)
SECTION II—Stamp Reconciliation
9. Balance of Virginia Cigarette Revenue Stamps on hand first day of month
+
+
10. Total Virginia Cigarette Revenue Stamps received during month (from Schedule B)
=
=
11. Total (add lines 9 and 10)
-
-
12. Total Virginia Cigarette Revenue Stamps affixed during month (from Schedule D)
-
-
13. Returns and Other Adjustments (see instructions)
=
=
14. Balance of Virginia Cigarette Revenue Stamps on hand last day of month (line 11 minus lines 12 and 13)
Report Verification and Contact Information
I, the undersigned, declare under penalties of perjury that I have examined this return and supporting schedules and to the best of my knowledge and belief, they are true, correct and
complete.
Print Name ______________________________________________________________________ Title or Position ___________________________________________________
Signature _______________________________________________________________________ Date ___________________________________________________________
Contact name ____________________________________________________________________ Telephone Number (________)_______________________________________
E-mail Address ___________________________________________________________________