Arizona Form 819nr - Nonresident Distributor'S Monthly Return Of Cigars And Tobacco Products Sold (For Nonresident Licensed Distributors) - Arizona Department Of Revenue Page 9

Download a blank fillable Arizona Form 819nr - Nonresident Distributor'S Monthly Return Of Cigars And Tobacco Products Sold (For Nonresident Licensed Distributors) - Arizona Department Of Revenue in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Arizona Form 819nr - Nonresident Distributor'S Monthly Return Of Cigars And Tobacco Products Sold (For Nonresident Licensed Distributors) - Arizona Department Of Revenue with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

AZ FORM 819NR

Schedule B-5

Sales of Cigars and/or Tobacco Products Sold During the Month on Arizona Indian Reservations –

that have enacted but do not collect their own tax which exempts tribal members

LEGAL BUSINESS NAME

BUSINESS (OR DBA) NAME

TOBACCO LICENSE NO.

RESERVATION NAME

FOR THE MONTH OF

MONTH YYYY

Include copies of invoices. Please see instructions and deﬁ nitions beginning on page 17.

“-1” R

No. of Small

No. of Ounces Sold

ETAILERS

Cigars Sold

No. of Cigars Sold

Smoking Tobacco,

No. of Ounces Sold

Invoice

weighing not more

for

Snuff, Fine Cut

Cavendish, Plug,

Registration Number

Name of Purchaser

Date

Number

than 3 lbs/1000

$.05 or less

more than $.05

Chewing, etc.

or Twist

1. Totals ...........................................................................................................................................

2. Quantity of line 1 sold tax free.....................................................................................................

$.263 per 20

$.130 per 3

$.130 each

$.133 per oz.

$.033 per oz.

TOTAL RATES.............................................................................................................................

$.263 per 20

$.130 per 3

$.130 each

$.133 per oz.

$.033 per oz.

3. Net amount due distributor for taxes paid but not collected ........................................................

4. Quantity of line 1 sold on which only the §42-3251 and §42-3251.01 rates were collected .......

$.040 per 20

$.020 per 3

$.020 each

$.020 per oz.

$.005 per oz.

§42-3052 RATES ........................................................................................................................

$.040 per 20

$.020 per 3

$.020 each

$.020 per oz.

$.005 per oz.

5. Net amount due distributor for taxes paid but not collected ........................................................

6. Total amount due distributor for taxes paid but not collected from “-1” Retailers (sum of lines 3 and 5).......................................................................................................................

“-2” R

ETAILERS

(Include sales to unregistered retailers.

Invoice

Small Cigars

Cigars

Ounces

Registration Number

Name of Purchaser

Date

Number

3 lbs/1000 or less

$.05 or less

more than $.05

Tobacco, etc.

Cavendish, etc.

7. Totals ...........................................................................................................................................

8. Quantity of line 7 sold tax free.....................................................................................................

$.263 per 20

$.130 per 3

$.130 each

$.133 per oz.

$.033 per oz.

TOTAL RATES.............................................................................................................................

$.263 per 20

$.130 per 3

$.130 each

$.133 per oz.

$.033 per oz.

9. Net amount due distributor for taxes paid but not collected ........................................................

10. Total amount due distributor for taxes paid but not collected from “-2” retailers (sum of line 9)....................................................................................................................................

11. Total amount due distributor for taxes paid but not collected (sum of lines 6 and 10). Enter here and on page 1, line 4b .................................................................................

Page 9 of 17

ADOR 14-5322f (8/05)