Tobacco Tax Report Form - City Of Tuscaloosa - Alabama
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1City
of
Tuscaloosa
TOBACCO
TAX
REPORT
MAIL
THIS
RETURN WITH
REMITTANCE TO
CITY
OF TUSCALOOSA REVENUE
DEPT
P
O
BOX
2089
TUSCALOOSA
AL
35403
PHONE
205
248 5200
FAX
205
349
0180
INDICATE
ANY
CHANGE BELOW
Additional
forms
needed
Out
of
Business
Date
Location
Change
Reporting
Period
Mailing
Address
Change
A
B
C
Gross
Tax Due
Column A
x
Column B
Type
of
Tax
Tax Area
Total
Quantity
Sold
Tax Rate
IGARETTES
City
lO per
package
Police Jurisdiction
05
pkg
0 10
0
05
IGARS
sold
individually
City
03 each
Police Jurisdiction
015
each
03
0 015
LL OTHER TOBACCO PRODUCTS
City
lO
per
package
Police Jurisdiction
05
pkg
This
return
must
be
postmarked by
the
20th
day
ofthe month
following
the
reporting period
for which
you
are
filing
to
be considered
a
timely
return
Failure
to
file
a
timely
return
will result
in
the
assessment
of
a
lO
penalty
and
interest
of
1
per
month
By signing
this report
I
am
certifying
that
this report
including
any
accompanying
schedules
or
statements
has been
examined
by
me
and
is
to
the
best of
my
knowledge
and belief
a
true
and
complete
report for
the
period
stated
10
0 05
1
Total Tax Due
Total of Column
C
2
Penalty
Line I
x
10
3 Interest
Line I
x
I
each
month
delinquent
4 Net Tax Due
Line I
if
delinquent
I
2
3
Signature
Date
5 Credit
Attach Documentation
6 Total Amount Due
Enclosed Line 4
5
Printed
Name
Phone
City of
Tuscaloosa Tobacco Ordinance 6085
adopted
August
31 2000 and Ordinance 6199
adopted
June 19 2001
as
amended
TOBACCO
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