Cigarette Tax Worksheet - Montana Department Of Revenue Page 2

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For the month of ________________________, 20 _____
Business name _____________________________________________ License Number _________________
Section 2 – Cigarette Decals Reconciliation
Decal package type
Roll
Sheet
Sheet
20/pack
20/pack
25/pack
decals
decals
decals
Total
Individual decal tax type
(A)
(B)
(C)
(A + B + C = D)
8. Beginning of period inventory ....................
9. Total decals purchased during period ........
10. Total decals (Add line 9 and line 10) .........
11. Deduct number of damaged decals ...........
12. Deduct: Period ending inventory ...............
13. Total taxable decals affixed (subtract line
11, and 12 from 10) ...................................
14. Decal taxable value
$1.70
$1.70
$2.125
15. Total tax value of decals............................. $
$
$
16. Total tax value (add line 15A, 15B, and 15C)......................................................................
$
17. Total distribution into Montana
(multiply line 4 of section 1 by $0.085/cigarette) ................................................................
$
18. Difference between the 2 lines above (subtract line 17 from line 16) ................................
$
19. Deduct total value of exempted sales (multiply total schedule C by $0.085/cigarette) .......
$
20. Total Montana cigarette tax collected (subtract line 19 from line 17)..................................
$
I hereby swear and affirm under penalty of false swearing that the information herein and attachments are true
and correct to the best of my knowledge.
Print Name of Principal or Agent
Date
Signature of Principal or Agent
Page 2
305

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