Form 70-018a - Iowa Cigarette Tax Report Out Of State Distributors

Iowa Cigarette Tax Report

Iowa Department of Revenue

Out-of-State Distributors

RETURN FOR MONTH OF ________________________ YEAR ______________

FOR OFFICE USE ONLY

DUE DATE: On or before the 10th day of the month following the

Postmark Date:

_________________

month for which the report is made.

Audit Period: _____________________

PERMIT NO: ____________________________________

MAIL THIS FORM TO:

Iowa Department of Revenue

NAME: _____________________________________

PO Box 10456

ADDRESS: _____________________________________

Des Moines, Iowa 50306-0456

OR FAX IT TO: 515/281-3756

_____________________________________

FOR ASSISTANCE, CALL: 515/281-8023

_____________________________________

Cigarette reports and all supporting documentation

SECTION I.

are required to be maintained for five years.

IOWA REVENUE INDICATOR PURCHASES DURING THE MONTH

Contraband: Only approved brands of cigarettes

Quantities

Gross Total

may be sold in Iowa. Any product not on the list is

Stamps For

in Dollars and Cents

contraband.

Go to /business/CigTobIndex.html

Date

Packs of 20

Packs of 25

Total Order

Filing Information

Civil penalty starts at $200.00 for late filed,

incomplete or false reports.

Penalty for failure to timely pay the tax due or

penalty for audit deficiency: A penalty of 5% will

be added to the tax due if at least 90% of the correct

amount of tax is not paid by the due date. The penalty

can be waived only under limited circumstances.

Interest: Taxes payable are subject to interest at

the rate prescribed by law and accrues on the unpaid

tax from the due date of this return. Any fraction of a

month is considered a whole month for purposes of

computing interest. Interest cannot be waived.

TOTALS:

To line 2 of Section 2.

SECTION II. SUMMARY OF REVENUE AND INDICATOR AVAILABILITY

1. Beginning inventory (prior month’s ending inventory)

20’s

Quantity

25’s

a. Unaffixed stamps ........................................................................1a __________________

________________

b. Affixed stamps .......................................................................... 1b __________________

________________

c. Subtotal. Add a and b. ................................................................1c _________________

_______________

2. Iowa purchases from Section 1 .......................................................... 2 __________________

________________

3. Subtotal. Add lines 1c and 2. ............................................................. 3 _________________

_______________

4. Ending inventory (current month’s stamps)

a. Unaffixed stamps ........................................................................4a __________________

________________

b. Affixed stamps .......................................................................... 4b __________________

________________

c. Subtotal. Add a and b. ................................................................4c _________________

_______________

5. Balance. Subtract line 4c from line 3. ............................................... 5 _________________

________________

6. Summary of Iowa sales from Section 3 on back ............................... 6 __________________

________________

The amount on line 5 should equal the amount on line 6.

7. Stamped cigarettes returned to manufacturer .................................... 7 __________________

________________

I declare that I have examined this report and to the best of my knowledge and belief, it is a true, correct and complete report.

Authorized Signature: ______________________________________________ Telephone Number: _________________________

Title of Officer: ___________________________________________________ Date: ___________________

70-018a (5/21/04)

Form 70-018a - Iowa Cigarette Tax Report Out Of State Distributors - 2004

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