Form Otp-906 - Other Tobacco Products Tax Licensed Distributor'S Monthly Return
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1
2INDIANA DEPARTMENT OF REVENUE
OTP-906
Other Tobacco Products Tax Licensed
SF# 46853
(R4 / 3-09)
Distributor's Monthly Return
Reporting Period______________Year________
IMPORTANT: A return must be filed each period within 15 days from the end of the reporting period even if there is no tax due.
Name of Licensed Distributor (As indicated on license)
OTP License Number
Address
Federal I.D. Number or SSN
City
State
Zip Code
1.
Receipts of Other Tobacco Products (From Attached Schedule 907)………………………………
1.
2.
Shipped Out-of-State (From Attached Schedule 907)………………………………………………
2.
3.
Returned to Manufacturer (From Attached Schedule 907)…………………………………………
3.
4.
Destroyed By Distributor (From Attached Schedule 908)…………………………………………
4.
5.
Sales to Federal Government (From Attached Schedule 907)………………………………………
5.
6.
Tax Paid Purchases from other Licensed Distributors (From Attached Schedule 907)……………
6.
7.
Bad Debt Deduction (From Line 12 of Attached Schedule OTP-BD)……………………………
7.
8.
Total Deduction (Add Lines 2, 3, 4, 5, 6, and 7)……………………………………………………
8.
9.
Total Taxable Tobacco (Line 1 minus Line 8)………………………………………………………
9.
10.
Tax Due (Multiply Line 9 by 24% [.24])……………………………………………………………
10.
11.
Less Collection Allowance (Multiply Line 10 by .006. Only allowed if timely filed.)……………
11.
12.
Tax Due or Refund……………………………………………………………………………………
12.
13.
Penalty (10% of tax rate due or $5.00 whichever is greater if filed late)……………………………
13.
14.
Interest (at current rate)………………………………………………………………………………
14.
15.
Refund Claimed (See Instructions Line 15)…………………………………………………………
15.
16.
Total Remittance (Attach check or money order)…………………………………………………… 16.
Make check or money order payable to:
Indiana Department of Revenue
Indiana Department of Revenue
Mail to:
P.O. Box 6114
Indianapolis, IN 46206-6114
I hereby declare under penalties of perjury that the information contained in this return, including accompanying schedules and statement, is true,
correct, and complete to the best of my knowledge and belief.
For questions related to the form, call (317)615-2710
For Department Use Only
Signature of Taxpayer or Agent
Title
A
B
Telephone Number
Date
C
D
E
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