Montana Form Tp-101 - Tobacco Product Tax

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MONTANA
TP-101
Rev 7-05
Tobacco Product Tax
(Title 16, Chapter 11, MCA)
Business Name
License No.
Date
Principal or Agent Name
Phone
Address
Fax
City
State
Zip
Tobacco (other than cigarettes) and moist snuff products sales for month of ___________________ , 20 ____
Instruction for form preparation
1. Prepare in duplicate. Submit the original to Montana Department of Revenue, Customer Intake Process, P.O. Box
1712, Helena, MT 59604-1712, with payment. Retain a duplicate in company file for field audit purposes.
2. Attach to reporting forms with payment made payable to the Montana Department of Revenue.
3. If a credit is claimed on line 11, a copy of TP-102 must be attached.
4. This form must be post marked by the 15th day of each month covering tobacco products received by Montana
retailers during the preceding month.
Section 1 – Other tobacco product tax reconciliation
1. Total sales of tobacco products (total column B, section 2) .................................... $ ____________________
2. Tobacco product tax rate .........................................................................................
0.50
3. Tobacco products tax (multiply line 1 by line 2) ...................................................... $ ____________________
4. Total weight of moist snuff product sold (total column C, section 2) ........................ __________________
OZ
5. Moist snuff product tax rate ...................................................................................... $
0.85/oz
6. Moist snuff product total tax (multiply line 4 by line 5) ............................................. $ ____________________
7. Total tobacco product tax and moist snuff tax (add line 3 and line 6) ..................... $ ____________________
8. Tobacco product tax discount rate ..........................................................................
0.015
9. Total tobacco product tax discount (multiply line 7 by line 8) .................................. $ ____________________
10. Total tobacco product tax less the discount (subtract line 9 from line 7) ................ $ ____________________
11. Total credit from TP-102, line 10, section 1 ............................................................. $ ____________________
12. Net total tobacco product tax due (subtract line 11 from line 10) ............................ $ ____________________
I hereby swear and affirm under penalty of false swearing that the information herein and attachment are true and
correct to the best of my knowledge.
Print Name of Principal or Agent
Date
Signature of Principal or Agent
Page 1
315

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