Form Cg-112.3 - Schedule C - Sales, Transfers, And Returns Of Unstamped Cigarettes Outside New York State - 2001

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New York State Department of Taxation and Finance
CG-112.3
Schedule C — Sales, Transfers, and Returns
(1/01)
of Unstamped Cigarettes Outside New York State
Transaction and Transfer Tax Bureau FACCTS/Cigarette Tax
Do not use this schedule to report sales or transfers of unstamped cigarettes made to persons or locations
within New York State.
File in duplicate
Filed with report for the calendar
Cigarettes transferred from New York State to: __________________________________
Month: _______
Year: ________
(state or province)
Complete a separate schedule for each state or province into which you shipped or
Federal identification number
transferred unstamped cigarettes, or to which you returned unstamped cigarettes.
Name
Agent’s license number
Street address
NYS sales tax identification number
City
State
ZIP code
Social security number
Part I. Sales and transfers —
include all sales and transfers of unstamped cigarettes to persons or business locations outside
New York State; see instructions
A
Enter number of cigarettes in the appropriate column(s)
Tax paid for state or
Name and address of person to whom unstamped
province other than
cigarettes were sold or transferred
New York State
10s
20s
25s
Miscellaneous
(enter Yes or No )
Total
(enter here and on line 1 below) ......................................................................................
Part II. Returns —
include all cigarettes that were returned to the manufacturer because they were received in error or were unsaleable;
see instructions
A
Enter number of cigarettes in the appropriate column(s)
Tax paid for state or
Name and address of manufacturer to whom unstamped
province other than
cigarettes were returned
New York State
10s
20s
25s
Miscellaneous
(enter Yes or No )
Total
(enter here and on line 2 below) ......................................................................................
Enter number of cigarettes in the appropriate column(s)
10s
20s
25s
Miscellaneous
Part III. Total sales, transfers, and returns
1 Total sales and transfers from Part I .............................................................................
2 Total returns from Part II .................................................................................................
3 Total
(add lines 1 and 2; enter here and on Form CG-6, line 7)
....................................
Attach a copy of this schedule to each Form CG-6.

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