Form Cg-5/6-Att - Schedule B - Cigarette Packages Stamped During The Month - State Of New York Page 2

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CG-5/6-ATT (2/02) (back)
Part II - Cigarette packs purchased from suppliers other than their manufacturers to which you affixed
New York State tax stamps this month.
Column D
Number of packs you affixed with New York State tax stamps
Column A
Column B
Column C
(either state only or joint state/city)
Packs of
Packs of
Packs of
Name, address, and FEIN
Brand(s) of
1 -10
11 -20
21 -25
Name, address, and FEIN of the first
of supplier
cigarettes
cigarettes
cigarettes
cigarettes
purchaser or manufacturer
(if known)
5 - Total packs listed in Part II .....................................................................................................................
6 - Total packs listed on attached additional Part II sheets .............................................................
7 - Total for Part II (add lines 1 and 2) . Enter result here and on the front page on line 3, Part I ....
Attach additional sheets if necessary

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