Form 73a422 - Monthly Report Of Other Tobacco Products And Snuff

ADVERTISEMENT

73A422 (4-09)
FOR DEPARTMENT USE ONLY
MONTHLY REPORT OF
Commonwealth of Kentucky
OTHER
1 0 1
/
/
/
__ __ __ __ __ __
__ __ __
__ __
__ __
DEPARTMENT OF REVENUE
TOBACCO PRODUCTS
Account Number
Tax
Mo.
Yr.
AND SNUFF
Return and payment are due by the 20th day of the month following the month in which the transactions occurred.
Name and Address of Principal or Agent
License/Account Number
Report for Month of
, 20
Telephone Number
(
)
Part I—Other Tobacco Products (must complete Part III)
The term “other tobacco products” means cigars, cheroots, stogies, periques, granulated, plug cut, crimp cut, ready rubbed, and other
smoking tobacco, cavendish, plug and twist tobacco, fi ne-cut, and other chewing tobacco, shorts, dry snuff, refuse scraps, clippings, cut-
tings and sweepings of tobacco, and other kinds and forms of tobacco prepared in a manner to be suitable for chewing or smoking in a
pipe or otherwise, or both for chewing or smoking but does not include cigarettes as defi ned in KRS 138.130(5), or moist snuff.
1.
Gross receipts from other tobacco products (include other tobacco products tax) .......................... $ _______________________
2.
Gross value of other tobacco products returned (include other tobacco products tax) .................... $ _______________________
3.
Total gross receipts subject to tax (subtract line 2 from line 1) ........................................................ $ _______________________
4.
Taxable receipts (divide line 3 by 1.15) ........................................................................................... $ _______________________
x
0.15
5.
Other tobacco products tax rate ........................................................................................................ ________________________
6.
Other tobacco products tax due (multiply line 4 by line 5) ........................................................ 01 $ _______________________
Part II—Snuff
The term “snuff’ means any fi nely cut, ground, or powdered tobacco that is not intended to be smoked. “Snuff’ includes “moist snuff”
sometimes referred to as “roll snuff” including the long cut and fi ne-cut varieties. Any smokeless tobacco product similar in composition
and makeup to snuff shall be taxed at the rates applicable to snuff.
7.
Total units of snuff sold ..................................................................................................................... ________________________
8.
Units returned .................................................................................................................................... ________________________
9.
Total units of snuff subject to tax (subtract line 8 from line 7) ......................................................... ________________________
x
0.19
10.
Snuff tax rate per unit (0.19) ............................................................................................................. ________________________
11.
Snuff tax due (multiply line 9 by line 10) ................................................................................. 02 $ _______________________
12.
Total due (add lines 6 and 11) ........................................................................................................... $ _______________________
IMPORTANT NOTICE:
Make check(s) payable to Kentucky State Treasurer.
Mail report and check(s) to Kentucky Department of Revenue, Frankfort, Kentucky 40619.
I, the undersigned, a principal offi cer of the above-named company, certify that I have examined this report and it is, to the best of my knowledge and belief,
a true, correct and complete report.
______________________________________________________ ________________________________________
Signature
Title
______________________________
_______________________________________________________________________
Date
E-Mail

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 2