Form Rpd-41318 - Application For Refund Of Tobacco Products Tax - 2011

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State of New Mexico - Taxation and Revenue Department
RPD-41318
Rev. 08/25/2011
APPLICATION FOR REFUND OF TOBACCO PRODUCTS TAX
WHO MUST FILE THIS FORM: Persons who have paid tobacco products tax on tobacco products destroyed or returned to the seller
by the first purchaser (see definitions in instructions) as spoiled or otherwise unfit for sale or consumption may use this form to claim a
refund. See Section I. Additionally, persons who have paid tobacco products tax on tobacco products on which an exempt sale ocurred
or the product was sold or given to an out-of-state purchaser after the reporting month in which the tobacco product was acquired may
use this form to claim a refund. See Section II. Submit Form RPD-41318, Application for Refund of Tobacco Products Tax, and required
attachments to New Mexico Taxation and Revenue Department, Tobacco Products Tax Unit, P.O. Box 25123, Santa Fe, NM 87504-5123.
For assistance call (505) 827-6842.
Name
Federal employer identification number
New Mexico CRS identification number
Mailing address
City, state and ZIP code
Name of person to contact
Contact telephone number
Contact E-mail address
SECTION I. Mark the box and complete this section if applicable:
c Taxpayer is due a refund of tobacco products tax paid on tobacco products destroyed or returned to the seller
by the first purchaser as spoiled or otherwise unfit for sale or consumption. Complete the table and complete
the statement using the total of the amounts listed in Column D. If additional space is needed, attach a separate page.
NOTE: Proof that the products were destroyed or returned and proof of the purchase price are necessary. An affidavit from the manufacturer and proof of
purchase and purchase price is satisfactory proof to the Department that the products were returned.
A
B
C
D
E
Type of
Date product
Tobacco
Name of seller to whom the tobacco
Product value
products returned
was returned or
product tax paid
product was returned, if applicable
or destroyed
destroyed
on product returned
or destroyed
$
$
$
$
$
$
$
$
I hereby certify that the State of New Mexico was overpaid the sum of ____________________________________dollars
in tobacco products taxes for the reasons stated in Section I.
SECTION II. Mark the box and complete this section if applicable:
c Taxpayer is due a refund of tobacco products tax paid on tobacco products on which an exempt sale ocurred
or the product was sold and shipped or sold and given to an out-of-state purchaser after the reporting month
in which the tobacco product was acquired. Attach amended returns for the report periods in which the tobacco
products tax was paid and complete the statement below.
I hereby certify that the State of New Mexico was overpaid the sum of ________________________ dollars in tobacco
II.
products taxes, for the period(s) _____________ to _____________, for the reasons stated in Section
I declare I have examined this application, including any attached schedules or statements, and to the best of my knowledge
and belief, it is true, correct and complete.
______________________________________________________________
_______________________________
Signature of taxpayer or agent
Date

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