Form Et-58 - Ohio Cigarette Tax Return - 2001

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Excise Tax Form
ET-58 (Rev. 3/01)
P.O. Box 530= Columbus, OH 43216-0530
Ohio Cigarette Tax Return
Notify immediately
if ownership or
address changes.
Ohio Cigarette Tax Return
for the period
______________ to ______________
State
Combined
County
Total
1.
Opening Tax Indicia Inventory
2.
Tax Indicia Purchased
3.
Tax Paid by Supplier
4.
Tax on Cigarettes
Returned by Customers
5.
Total Available
(Add lines 1, 2, 3 & 4)
6.
Closing Indicia Inventory
(Affixed and Unaffixed)
7.
Used on Exempt Sales
8.
Used on Cigarettes
Returned to Manufacturer
9.
Total Accounted for
(Add Lines 6, 7 & 8)
10.
Net Indicia Used
(Line 5 minus Line 9)
10A. State Portion (.842)
10B. County Portion (.158)

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