Form Cg-5/6-Att - Schedule B Cigarette Packages Stamped During The Month Page 2

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CG-5/6-ATT (12/99) (back)
Part II - Purchases from other sources
Include in Part II the number of New York State tax stamps you affixed during the month to packages of cigarettes that you purchased other than directly from the manufacturer. If you
have more than one supplier with respect to any brand of cigarette, list all suppliers for such brand(s). List below the name, address, and employer identification number of your supplier
and the brand(s) of cigarettes purchased from each such supplier. For each brand listed, enter the name, address, and employer identification number of the first purchaser or
manufacturer (if known) of the cigarettes. (The first purchaser is the person or other entity responsible for the cigarettes being designated for sale in the United States where
such cigarettes were not originally intended for sale in the United States by the manufacturer. If you have purchased cigarettes which have been re-packaged for sale in the
United States (i.e., required health warnings have been affixed), such cigarettes were not intended by their manufacturer to be sold in the United States. The manufacturer is
a cigarette manufacturer which manufactured cigarettes that it intended to be sold in the United States, including cigarettes intended to be sold in the United States through
an importer. These cigarettes have the required health warnings on the original packaging.) In addition, enter the number of New York State tax stamps you affixed during the
month (includes the joint state/city stamp) to each brand of cigarettes. Complete all columns and attach additional sheets if necessary.
Name, address and EIN of supplier
Brand(s) of cigarettes
Name, address, and EIN of the first
Enter the number of stamps you affixed in the appropriate columns
purchaser or manufacturer
(if known)
10’s
20’s
25s
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Totals from attached additional Part II
sheets ................................................................................................................................
Totals for Part II
(add the number of stamps affixed for each denomination; enter here and on the front) ......................................

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