Form Otp-3 - Other Tobacco Products Schedule A
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1Excise Tax Form
OTP-3 (7/01)
Excise and Motor Fuel Tax Division
P.O. Box 530 l Columbus, OH 43216-0530
Other Tobacco Products Schedule A
(Use additional pages if necessary)
Account No.
Name of Reporting Wholesale Dealer
Other Tobacco Products received by an Ohio Distributor
For the Month of ____________________
Page _____ of _____
Date
Invoice
Invoice
Name of
Gross
Received
Date
Number
Supplier
Invoice Price
Page Total
Grand Total
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Parent category: Financial