Wisconsin Distributor'S Tobacco Products Tax Return Form - State Of Wisconsin Page 2
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1
2SCHEDULE 2 - SALES TO TAX-EXEMPT ORGANIZATIONS
ROLL-YOUR-OWN (RYO) TOBACCO PRODUCTS:
(See TT-105a for defintion of “roll-your-own”.)
Instructions: Enter all tax exempt organizations (i.e. military post exchanges or state or federally operated veter-
Submit in duplicate when columns A, B, C & D completed.
ans’ hospitals.) Caution: Sales to Native American Indian Tribes/retailers in Wisconsin are NOT exempt.
Column D
Column A
Column B
Column C
Sold To
Invoice
*Manufacturer’s List Price
Total Ounces
Line
Name
City
Number
Date
Purchased From
Manufacturer
Brand Name
(per brand)
1
Balance Brought Forward . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
Balance brought forward . . . . . . . . . . . .
2
3
4
Dept. Use Only ➔
$
Total
5
Total Tax-Exempt Sales (do not enter on face of return)
SCHEDULE 3 - NONTAXABLE SALES
ROLL-YOUR-OWN (RYO) TOBACCO PRODUCTS:
(See TT-105a for defintion of “roll-your-own”.)
Instructions: Enter all nontaxable sales of tobacco products sent to any person or business in Wisconsin who holds
a WI tobacco products distributor permit (TPD). Include all samples, “free” products and promotional products.
Submit in duplicate when columns A, B and C completed.
Column A
Column B
Column C
Column D
Invoice
Sold To
*Manufacturer’s List Price
Total Ounces
Line
Number
Date
Name
Wis. Permit No.
Manufacturer
Purchased From
Brand Name
(per brand)
$
Balance brought forward . . . . . . . . . . . .
1
Balance Brought Forward . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
TPD –
3
TPD –
4
TPD –
5
TPD –
6
TPD –
7
TPD –
8
TPD –
9
TPD –
10
TPD –
11
TPD –
12
TPD –
13
TPD –
14
TPD –
15
TPD –
16
TPD –
17
TPD –
Dept. Use Only ➔
18
Total Nontaxable Sales (do not enter on face of return)
Total
$
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