Form 73a420 - Monthly Report Of Cigarette Wholesaler Page 2
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473A420 (2-12)
Page 2
SCHEDULE A—Packages of Cigarettes Received into Inventory
UNSTAMPED
If Purchased Directly from Importer, Provide Name
Date
Invoice
Invoice
Received
Number of
of Importer. Also, Provide Custom
Received
Number
Date
From
Packages
Certificates or Entry Number.
STAMPED
If Purchased Directly from Importer, Provide Name
Date
Invoice
Invoice
Received
Number of
of Importer. Also, Provide Custom
Received
Number
Date
From
Packages
Certificates or Entry Number.
Separate sheets may be used in lieu of Schedule A and attached to the report. ......................................................................................................... ➤ TOTAL
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