Form T-205s - Prepayment Of Sales Tax On Cigarettes printable pdf download

Form T-205s - Prepayment Of Sales Tax On Cigarettes

Rhode Island Division of Taxation

T-205S

Prepayment of Sales Tax on Cigarettes

This certificate must be completed by the seller and given to the purchaser with each delivery of cigarettes.

Name of seller

Name of purchaser

Street address

Street Address

City

State

ZIP code

City

State

ZIP code

Seller’s RI sales tax identification number

Purchaser’s RI sales tax identification number

Seller’s cigarette tax license number

PART 1

The selling price of the cigarettes delivered to the above purchaser includes the prepaid sales tax in the following amounts.

Date of purchase :

Number of Packs of Cigarettes Sold

Prepaid Sales Tax Per Pack

Invoice Number

Packs of 20

Packs of 25

The seller must check the certification that applies:

I am the stamping agent and I paid, or will pay, the prepaid tax, and I am passing this tax through to you, the

purchaser.

The stamping agent,

paid the prepaid tax as

(agent’s name)

indicated by certification to me, and I am passing this tax to you, the purchaser.

PART 2

TO THE SELLER: This certificate may be reproduced or incorporated into any invoice or other billing document if all the infor-

mation requested on this form is included.

TO THE PURCHASER: Attach this certificate to the invoice or delivery ticket covering the above purchase and keep these doc-

uments as part of your records for a three-year period. Failure to obtain and keep a copy of this certificate for each purchase of

cigarettes from the supplier will subject you to liability for prepaid taxes on that purchase.

PART 3

I certify that this certificate and any attachments are, to the best of my knowledge and belief, true, correct and complete.

Name of seller or authorized representative (type or print)

Signature of seller or authorized representative

Title

Date

A person who attempts to use this form to evade the prepaid tax on cigarettes will be subject to penalties as provided by Rhode

Island State Sales Tax Law.

Rev. 07/2005

Form T-205s - Prepayment Of Sales Tax On Cigarettes

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