Schedule A-1 - Record Of Moist Snuff Purchased, Imported, Received Or Acquired In New Jersey

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State of New Jersey - TPWST
Division of Taxation
Schedule A-1
(1/09)
Revenue Processing Center
Tobacco Products Tax
PO Box 280
Trenton, NJ 08646-0280
Record of Moist Snuff Purchased, Imported, Received or Acquired in New Jersey
NOTE: PROVIDE ONLY SUMMARY DATA BY SUPPLIER ON THIS SCHEDULE.
Name
________________________________________________________________
Period Ending (Month/Year) __________/__________
Address __________________________________________________________
FEIN _______________________________________
Enter the total of Schedule A-1 on line 7 of the Tobacco Products Tax Return. Attach Schedule A-1 to the return.
Column 1
Column 2
From Whom Purchased or Acquired (Name and Address)
Number of Ounces
Enter this amount on Line 7 of the Tobacco Products Tax Return.
Total
Make Additional Copies Of This Form If Necessary to Report The Required Information

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