Form Rev 82 2090e - Tax Declaration For Cigarettes - 2010
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State of Washington
OFFICIAL USE ONLY
Department of Revenue
Tax Declaration for Cigarettes
Period
Special Programs Division
PO Box 47477
Olympia, WA 98504-7477
Year
Tax Registration Number
Step 1 - Enter your name and address
Address changes? Check box and write your corrected address below.
______________________________________________________________________________________________________
Last Name (Please print)
First
Middle Initial
______________________________________________________________________________________________________
Street Address (Include apartment number)
______________________________________
______________
__________
______________________
City
State
Zip code
Telephone Number
Step 2 - To avoid duplicate billing, please provide the purchase information
______________________________________________________________________________________________________
Company Name
______________________________________________________________________________________________________
Month of Purchase(s)
______________________________________________________________________________________________________
Invoice Number(s)
Step 3 - To calculate taxes due, please follow the steps below
Tax Due
Tax Rate
Line #
Code
X
=
$30.25
$0.00
1. Cigarette Tax
(287)
Number of Cartons
2. Enter the amount of Tax Due from line 1
$0.00
3. Total amount paid
(including shipping and handling)
+
4. Add lines 2 and 3 to calculate the total
$0.00
Taxable Amount for sales/use tax
Location Code
enter the amount from line 4
Total Tax Rate
5. Sales/use tax owed
(05)
X
=
$0.00
$0.00
0.0%
(46)
Note: To determine the location code(s) and tax rate(s), use our Tax Rate Lookup Tool
located on our web site at dor.wa.gov. See page two for complete instructions.
6. Total - Cigarette and Use Tax Due (add tax due from lines 1 and 5)
$0.00
Step 4 - Payment information
Make check payable to: Department of Revenue
DUE DATE
Taxes are due within
Mail declaration and check to: Department of Revenue
72 hours of possession
PO Box 47464
Olympia, WA 98504-7464
Signature __________________________________________________
Date _______________________
Make a Copy for Your Records
CIG/JEN
Print This Form
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