Form 70-025 - Schedule Iii Credit Out-Of-State Sales

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Schedule III Credit
IOWA
Out-of-State Sales
d e p a r t m e n t o f R eve n u e a n d F i n a n c e
For Tobacco Products Other Than Cigarettes,
Sold Out of State
Credit for month of ____________________ 20 _____
Exports to State of * _________________________
License No: ___________________________________
*Complete a separate schedule for each state and submit in duplicate.
Name: _______________________________________
Invoice
Invoice
Sold to
Manufacturer’s
ü
date
number
Name
City
State
gross list price
1
$
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
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31
32
33
34
$
35
Enter on line 22 of form 70-022 or on line 1 of the next page.
Attach this schedule (two copies) to monthly return form 70-022. If you need additional space, attach separate sheets.
70-025 (9/26/00)

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