Form Cft - Cigarette Floor Tax Tax - State Of Virginia

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Form CFT
Commonwealth of Virginia
Cigarette Floor Tax
• All stamping agents must file this form.
• Only cigarette packs in inventory on hand as of 12:01 am on July 1, 2005, stamped with the old rate
Virginia Revenue
Stamp are subject to the floor tax.
Do not report unaffixed
old rate
stamps on this return. Unaffixed stamps are to be returned to the Department for credit
no later than June 30, 2005.
• This form must be filed and the floor tax paid to the Department of Taxation no later than July 11, 2005.
• Checks should be made payable to the Virginia Department of Taxation.
• Mail this form, with your payment, to: Department of Taxation
ATTN: Floor Tax
P. O. Box 1301
Richmond, VA 23218-1301
• If you have questions regarding this form or the Floor Tax, please contact the Fiscal Office at (804) 367-6345.
Name
Permit Number
Mail To:
Trading As
Department of Taxation
ATTN: Floor Tax
Number And Street
P. O. Box 1301
Richmond, VA 23218-1301
City or Town, State, ZIP Code
Use This Form To Calculate and Remit your 2005 Cigarette Floor Tax
A
B
Packages of 20's
Packages of 25's
1. Number of packs on hand 7/1/05 with 20¢/25¢ revenue stamp affixed
2. Cigarette Floor Tax Due (Line 2A = Line 1A X .1 Line 2B = Line 1B X .125)
$
$
3. Total Cigarette Floor Tax Due (Line 2, Column A plus Column B)
$
I hereby declare that this report is true and correct.
By
Signature and Title
Date
Telephone
Print Name
Email Address
If the stamping agent is a corporation, an officer of the corporation authorized to sign on behalf of the corporation must sign; if a partnership, one partner
must sign; if a sole proprietorship, the proprietor must sign.
Va. Dept. of Taxation Form CFT (REV 05/05)

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