Form Rpd-413115 - Cigarette Distributor'S Monthly Report Form - Taxation And Revenue Department - New Mexico
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7RPD-41315
State of New Mexico
Rev. 06/2007
Taxation and Revenue Department
CIGARETTE DISTRIBUTOR'S MONTHLY REPORT
Due on or before the 25th day of the month following the
Report for
close of the reporting month.
calendar month of: ___________________________
For assistance call (505) 827-6842.
Federal employer identification number
Name and address of facility
Social security number
New Mexico CRS identification number
New Mexico distributor's license number
Telephone number and e-mail address
Name of contact person
Important: When completed properly negative amounts are not reported on the Cigarette Distributor's Monthly Report or Sched-
ules. See Negative Amounts Not Allowed on page 2 of the instructions.
By number of packages
Section I - Unstamped Cigarette Inventory Reconciliation
Outside NM
Inside NM
1. Beginning inventory of unstamped cigarettes for distribution or sale outside
New Mexico (Include non-dedicated unstamped inventory.) ................................... 1.
2. Beginning inventory of unstamped cigarettes for distribution or sale inside
New Mexico.(Must be stamped within 10 days of receipt.) .............................................................. 2.
3. Plus unstamped cigarettes received and held for distribution or sale outside
+
New Mexico (from Schedule B). ............................................................................ 3.
4. Plus unstamped cigarettes received and held for distribution or sale inside
New Mexico (from Schedule B). ...................................................................................................... 4.
+
5. Less cigarettes to which a New Mexico Cigarette Tax Stamp is affixed during
-
the report month. (Also enter on line 10.) ........................................................................................ 5.
6. Less unstamped cigarettes distributed for sale outside New Mexico and
-
other reductions to inventory (from Schedule C). ................................................... 6.
7. Ending inventory of unstamped cigarettes for distribution or sale outside
New Mexico.
7.
=
(Subtract line 6 from the sum of lines 1 and 3.) ..........................................................
8. Ending inventory of unstamped cigarettes for distribution or sale inside New
=
Mexico.
8.
(Subtract line 5 from the sum of lines 2 and 4.) ....................................................................................................
By number of packages
Section II - Stamped Cigarette Inventory Reconciliation
9. Beginning inventory of New Mexico stamped cigarettes. ...................................................... 9.
+
10. Plus cigarettes to which New Mexico cigarette tax stamp has been affixed
10.
(from Line 5). ......
+
11. Plus stamped cigarettes received (from Schedule B). ........................................................ 11.
-
12. Less stamped cigarettes distributed and other reductions (from Schedule C). ................... 12.
13. Ending inventory of New Mexico stamped cigarettes.
(Subtract line 12 from the sum
=
13.
of lines 9, 10 and 11.) ............................................................................................................................................
Section III - Unaffixed New Mexico Cigarette Tax Stamp Inventory
By number of stamps
20's
25's
stamp (0.91)
stamp (1.1375)
Tax-exempt
14. Beginning inventory of unaffixed stamps.
15. Plus stamps received from the Department.
+
16. Less stamps which have been spoiled or returned for refund.
-
17. Less stamps applied (from line 5).
-
18. Ending inventory of stamps unaffixed to cigarettes.
=
Under penalty of perjury, I declare that I have examined this application and all attachments and to the best of my knowledge and belief it is true,
correct and complete.
Signature of applicant ___________________________________ Date _____________ Phone ___________
Mail To:
New Mexico Taxation and Revenue Department, Cigarette Tax Unit, P.O. Box 25123, Santa Fe, NM 87504-5123
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