Cigarette Tax Worksheet - Montana Department Of Revenue Page 4

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Schedule B –Wholesaler, and exempted unstamped cigarette and out-of-state retailer sales recap

(To be completed by Montana wholesalers only)

For the month of ________________________, 20 _____

Business name _____________________________________________ License Number _________________

Part 1 – Wholesaler, and exempted sales of unstamped cigarettes

Number of

Sales Invoice

Sold to:

Cigarettes

Date

Number

Name

Address

City

State

Zip

Enter total from previous page, if any .................................................................................................................

Total cigarettes this page .................................................................................................................................

Total cigarettes – If this is the final page, enter total value from all pages on CT-205 line 5, section 1 ..

Part 2 – Out-of-state retail sales