Form Ctx-Ftr - City Of New York Cigarette Floor Tax Return - 2002 Page 2

Page 2 of 4

CTX-FTR (6/02)

Schedule A - Consolidated filers

The schedule below must be completed by vendors who are filing one floor tax return for cigarettes bearing joint New York State

and New York City tax stamps that are stored, kept, or offered for sale at more than one location. Report the inventory of joint

stamped packs of cigarettes on hand as of the close of business on July 1, 2002, at each location. Keep the original inventory

report for inspection at each location.

Note: 2 packs of 10 = 1 pack of 20

1 pack of 25 = 1.25 packs of 20

Give totals by packs of 20 cigarettes, not cartons, at each location

Number of packs with

Business name, address, and federal employer identification number (FEIN) or social security

New York State and New

number of each location where cigarettes are stored, kept, or offered for sale.

York City joint stamps

Total

Include total on line 5 on page 1

— Attach additional sheets if necessary —

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