Arizona Form 800-25 - Cigarette Distributor'S Monthly Return - Arizona Department Of Revenue Page 12
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12AZ FORM 800-25
Instructions
Column (f): Enter number of green stamped 25s sold.
distributor affi xed the excise stamp of this state or otherwise paid
state excise taxes.
Total by Reservation: Enter total of each column.
Column (a): Enter the name of the participating manufacturer of
Balance forwarded from other reservations: Enter the totals of
the brand family of cigarettes reported in Column (c).
each attached Schedule B.
Column (b): Enter the name and address of person(s) from
Grand total of all reservations.
whom purchased if other than the participating manufacturer, of
the brand family of cigarettes reported in Column (c).
Special Instructions for Schedule C-1
Column (c): Enter the brand family of the cigarettes received
Export of Participating Manufacturer’s Cigarettes (except roll-
your-own tobacco)
(do not abbreviate). Do not break the brand family down into
subcategories such as regular, menthol, light, etc. For example,
Use separate sheets for each state. Submit a copy to the taxing
for a cigarette named “Alpha Bravo Gold Menthol Lights”, report
authority of the state of destination of the exempt luxury. If
only “Alpha Bravo Gold”. Do not report as “A B Gold” or “A B Gold
cigarettes are tax-paid for consignee state and are delivered
Menthol Lights.”
to retailers or placed in vending machines in that state, it is not
Column (d): Enter the number of packages of 25 cigarettes
necessary to show the detail of such sales. Show such sales
for which the distributor affi xed the excise stamp of this state or
on one line with notation, “Sold to dealers or placed in vending
otherwise paid state excise taxes during the month.
machines tax-paid.”
Column (a): Enter the date of shipment of transfer out of state.
Special Instructions for Schedule A-4
Nonparticipating Manufacturer’s (NPM) Cigarettes Stamped
Column (b): Enter the invoice number of the product shipped into
for Sale in Arizona (except roll-your-own tobacco).
another state.
Column (c): Enter the name and address of the participating
This report must be completed for every cigarette brand family
(excluding roll-your-own tobacco) manufactured by a NPM for
manufacturer from whom product was received.
which the distributor affi xed the excise tax stamp of this state or
Column (d): Enter the name, address, and city of the company
otherwise paid state excise taxes.
or person to whom cigarettes were sold or transferred.
Column (a): Enter the name and address of the nonparticipating
Column (e): Enter the brand family of the product sold or
manufacturer of the brand family of NPM cigarettes reported in
transferred out of state.
Column (d).
Column (f): Enter the number of packages of 25 cigarettes.
Column (b): Enter the name and address of the person from
Column (g): Indicate whether or not the shipped cigarettes were
whom the NPM cigarettes reported in Column (d) were purchased
if different from the NPM identifi ed in Column (a).
tax-paid for the consignee state.
Column (c): Enter the date and invoice number of the invoice
Special Instructions for Schedule C-2
pursuant to which you purchased or acquired the cigarettes
Export of Nonparticipating Manufacturer’s (NPM) Cigarettes
identifi ed in Column (d).
(except roll-your-own tobacco)
Column (d): Enter the brand family of the NPM cigarettes
Use separate sheets for each state. Submit a copy to the taxing
(do not abbreviate). Do not break the brand family down into
authority of the state of destination of the exempt luxury.
subcategories such as regular, menthol, light, etc. For example,
Column (a): Enter the date of shipment of transfer out of state.
for a cigarette named “Alpha Bravo Gold Menthol Lights”, report
only “Alpha Bravo Gold”. Do not report as “A B Gold” or “A B Gold
Column (b): Enter the invoice number of the product shipped into
Menthol Lights.”
another state.
Column (e): Enter the number of individual NPM cigarettes or
Column (c): Enter the name and address of the nonparticipating
packages of 25 cigarettes, excluding roll-your-own, for which the
manufacturer from whom product was received.
distributor affi xed the excise tax stamp of this state or otherwise
Column (d): Enter the name, address, and city of the company
paid state excise taxes.
or person to whom cigarettes were sold or transferred.
Special Instructions for Schedule B
Column (e): Enter the brand family of the product sold or
Sales to Indian Retailers on the Reservation
transferred out of state.
Complete a separate Schedule B for each reservation.
Column (f): Enter the number of packages of 25 cigarettes.
List all sales to authorized Indian retailers. For a current list of
Column (g): Indicate whether or not the shipped cigarettes were
retailers authorized to receive red or green stamped cigarettes,
tax-paid for the consignee state.
call the Arizona Department of Revenue Tobacco Tax Section at
(602) 716-7808. Each transaction must include the following:
Certifi cation of No NPM Activity:
Column (a): Enter the registration number and name of the
If you have not engaged in any activity required to be reported
retailer.
on Form 819, Schedule A-3 or A-5; Form 800-20, Schedule
Column (b): Enter invoice date.
A-2 or A-4; or Form 800-25, Schedule A-2 or A-4, during the
Column (c): Enter invoice number.
applicable period, you must complete and submit the form,
Resident Distributor’s Certifi cation of No Nonparticipating
Column (d): Enter number of blue stamped 25s sold.
Manufacturer Activity (In Lieu of Nonparticipating
Column (e): Enter number of red stamped 25s sold.
Manufacturers Schedules).
Page 12 of 12
ADOR 14-2042f (6/05)
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