Form Otp 01 - Other Tobacco Products (Otp) Excise Tax Return Page 2
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4NEVADA DEPARTMENT OF TAXATION
1550 East College Parkway, Room #115
Carson City, Nevada 89706
(775) 687-6483
OTHER TOBACCO PRODUCTS (OTP) FORM 2
Please use separate form for each type of transaction
OTP License No.
Return for month ending
Wholesale Dealer
Mailing Address
OTP exported from Nevada for retail sale and consumption out of state
OTP sold to a tribal smoke shop
OTP sold to the U.S. Military (Army, Air Force, Navy, Marine Corp)
OTP returned to the manufacturer (credit memo from manufacturer must be attached)
DATE
INVOICE NO.
NAME OF CUSTOMER
ADDRESS OF CUSTOMER
WHOLESALE PRICE
TOTAL WHOLESALE PRICE: $
OTP 02
Revised 08/01/01
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