Form Rpd-41311 - Cigarette Manufacturer'S Monthly Report
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1
2State of New Mexico
RPD-41311
Rev. 05/2010
Taxation and Revenue Department
CIGARETTE MANUFACTURER'S MONTHLY REPORT
1
Page ____ of ____
Report for calendar month of: ___________________________
Due on or before the 25th day of the month following the close of the report month.
Federal employer identification number
Name and address of facility
Social security number
New Mexico CRS identification number
Telephone number and e-mail address
New Mexico manufacturer's license number
Name of contact person
For assistance call (505) 827-6842
Report unstamped packages of cigarettes distributed or sold:
• to another manufacturer, distributor or export warehouse proprietor within New Mexico, or
• inside New Mexico to another facility owned by the same manufacturer.
DISTRIBUTED CODE TABLE
DISTRIBUTED CODE
Code
Distributed or sold:
For each entry, enter the code from the
N ....................................
to another manufacturer, distributor or export warehouse proprietor who is an Indian nation, tribe or pueblo in New
Distributed Code Table, to indicate the entity
Mexico, or to a tribal member located on the Indian nation, tribe or pueblo in New Mexico. NOTE: Manufacturers
may not sell unstamped cigarettes to retailers.
to which the packages of cigarettes were
distributed.
F ....................................
to another facility in New Mexico of the same manufacturer.
NM .................................
to another manufacturer, distributor or export warehouse proprietor in New Mexico.
Distributed
Distributed to:
Number of pack-
Brand Family
Code
(Enter name and address.)
ages of cigarettes
From all pages of this report, enter the total quantity of packages of cigarettes distributed in
New Mexico.
Under penalty of perjury, I declare that I have examined this report and all attachments and to the best of my knowledge and belief it is true, correct and
complete.
Signature of authorized agent ____________________________ Date ____________ Phone ____________ E-mail address __________________
Mail to: New Mexico Taxation and Revenue Department, Cigarette Tax Unit, P.O. Box 25123, Santa Fe, NM 87504-5123
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