Other Tobacco Products Excise Tax Return Form
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5NEVADA DEPARTMENT OF TAXATION
TID & LOC:
OTHER TOBACCO PRODUCTS
EXCISE TAX RETURN
FOR DEPARTMENT USE ONLY
MAIL ORIGINAL TO: NEVADA DEPARTMENT OF TAXATION
1550 COLLEGE PARKWAY SUITE 115
Postmark Date:__________________________________
CARSON CITY NV 89706
Amount: $______________________________________
Check #:_______________________________________
Received By:____________________________________
Posted By:______________________________________
FOR MONTH ENDING:
If the name or address shown is incorrect, if the ownership or business location has changed,
or if you are out of business, please contact the Carson City Department of Taxation.
If paid after due date collection allowance is not allowed
DUE ON OR BEFORE:
IF POSTMARKED AFTER DUE DATE, PENALTY AND INTEREST WILL
APPLY
A RETURN MUST BE FILED EVEN IF NO TAX LIABILITY EXISTS
FOR OFFICE USE ONLY
1.
$
TOTAL WHOLESALE PRICE OF PRODUCTS SOLD OR DISTRIBUTED
CREDIT FOR SALES TO OUT OF STATE CUSTOMERS
2.
$
(OTP FORM 2 MUST BE ATTACHED)
CREDIT FOR SALES TO TRIBAL CUSTOMERS AND/OR MILITARY
3.
$
(OTP FORM 2 MUST BE ATTACHED)
$
CREDIT FOR SALES OF WHICH TAX WAS PREVIOUSLY PAID
4.
$
(OTP FORM 4 MUST BE ATTACHED)
$
CREDIT FOR RETURNED MERCHANDISE
5.
$
(OTP FORM 2, COPY OF MFG CREDIT MEMO, AND CUSTOMER CREDIT MEMO MUST BE ATTACHED)
$
TOTAL SALES SUBJECT TO EXCISE TAX
6.
$
(LINE 1 MINUS LINE 2, MINUS LINE 3,MINUS LINE 4, MINUS LINE 5)
$
7.
TAX
$
(30% OF LINE 6)
8.
COLLECTION ALLOWANCE
$
(.025% (.0025) OF LINE 7)
9.
NET TAX DUE (LINE 7 MINUS LINE 8)
$
LESS CREDITS APPROVED BY THE DEPARTMENT
10.
$
(COPY OF CREDIT MEMO MUST BE ATTACHED)
$
11.
$
TAX DUE
(LINE 9 MINUS LINE 10)
12.
$
PENALTY (For periods prior to April 1, 2007 the penalty is 10%)
13.
$
INTEREST
(1% OF LINE 11 FOR EACH MONTH OR FRACTION THEREOF)
14.
$
PLUS LIABILITIES ESTABLISHED BY THE DEPARTMENT
15.
$
TOTAL AMOUNT DUE
AMOUNT REMITTED WITH RETURN
16.
$
(MAKE CHECKS PAYABLE TO: NEVADA DEPARTMENT OF TAXATION)
I HEREBY CERTIFY THAT THIS RETURN INCLUDING ANY ACCOMPANYING SCHEDULES AND STATEMENTS HAS BEEN EXAMINED BY ME AND TO THE
BEST OF MY KNOWLEDGE AND BELIEF IS A TRUE, CORRECT AND COMPLETE RETURN.
OTP-01
REVISED 01-01-08
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