Form Mt-203-W-A - Acquisitions Of Tobacco Products Page 2
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2MT-203-W-A (11/10) (back)
Schedule 2 — Acquisitions of snuff
C
D
Name and address of supplier
EIN of supplier
Snuff containers of less than one ounce
Snuff containers of one ounce or more
No. of individual containers
Purchase price
Ounces of snuff
Purchase price
A
B
C
7 Total acquisitions from this Schedule 2
8 Total acquisitions from additional attached sheet(s), if any
9 Total acquisitions
(add lines 7 and 8; enter here and on
Form MT-203-W, line 2, columns C and D)
10 Total purchase price from this Schedule 2
11 Total purchase price from additional attached sheet(s), if any
12 Total purchase price
(add lines 10 and 11)
Schedule 3 — Acquisitions of little cigars
E
Number of packs of little cigars
Name and address of supplier
EIN of supplier
No. of packs
Purchase price
A
B
C
13 Total acquisitions from this Schedule 3
14 Total acquisitions from additional attached sheet(s), if any
15 Total acquisitions
(add lines 13 and 14; enter here and on
Form MT-203-W, line 2, column E)
16 Total purchase price from this Schedule 3
17 Total purchase price from additional attached sheet(s), if any
18 Total purchase price
(add lines 16 and 17)
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Parent category: Financial