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REVENUE USE ONLY
2007 OREGON QUARTERLY TAX RETURN
Form
Date Received
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FOR TOBACCO PRODUCTS
531
(Other than Licensed Distributor)
Reporting Period
Social Security No.
Oregon Business ID No.
Program Code Year
Period
Liability Payment Received
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•
•
•
•
•
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1st
531
07
03
1
Quarter: _______
Please use blue or black ink when filling out this form.
Type of business:
Individual
Partnership
Corporation
Other: ________________________
Complete Schedule A (below) before filling in lines 1–12.
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1. Number of cigars at purchase price of 77 cents or more
..............1
(from 7a)
2. Multiply the number of cigars by 50 cents (line 1 × 0.50) ............................................................. 2
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3. Purchase price of cigars at purchase price of less than 77 cents
...3
(from 7b)
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4. Purchase price of all other tobacco products
...............................4
(from 7c)
5. Total of lines 3 and 4 ..................................................................................5
6. Multiply line 5 by 0.65 .................................................................................................................. 6
7. Total quarterly tax (add lines 2 and 6) .......................................................................................... 7
8. Quarterly tax discount (multiply line 7 by 0.015) .......................................................................... 8
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9. Net tax due (line 7 minus line 8) .................................................................................................. 9
10. Penalty and interest (see instructions) ....................................................................................... 10
11. Total amount due (add lines 9 and 10)......................................................................................11
Schedule A—
List each tobacco product purchased this quarter (add additional pages if needed).
Invoice
Number of cigars
Price of products purchased
Manufacturer or supplier
from whom tobacco products were purchased
Number
Date
b. Cigars—less than 77¢
c. Other tobacco products
a. (Purchase) price of 77¢ or more
1.
2.
3.
4.
5.
6.
7a.
7b.
7c.
7.
Add and enter totals for each column. Enter column totals on corresponding
lines 1, 3, and 4 at the top of the form.
DECLARATION
I declare under the penalties for false swearing [ORS 305.990(4)] that I have examined this document and to the best of my knowledge it is true, correct, and complete.
Signature
Date
PRINT Name Signed Above
Title
Telephone No.
(
)
150-605-006 (Rev. 12-06)
Please read the instructions