Form Cg 1501 -Np - Idaho Activity For Nonparticipating Cigarette Brands

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CG 1501-NP
EFO00144
12-16-08
Tobacco Master Settlement Agreement
Idaho State Tax Commission
Idaho Activity for Nonparticipating Cigarette Brands
Name:
EIN:
Tax Period:
Permit Number:
Use this schedule to report the cigarettes purchased from nonparticipating manufacturers and then stamped and sold in Idaho. You must complete this
schedule in addition to completing the Idaho Cigarette Tax Return CG 1550 and all required supporting schedules. To find a list of participating manufacturers
and brands online, go to www2.state.id.us/ag/consumer/tobacco/directory_index.htm. For more information on the Tobacco Master Settlement Agreement,
please visit the Idaho Attorney General’s Web site at www2.state.id.us/ag/consumer/tobacco/msa.htm.
c.
a.
b.
d.
e.
f.
Brand
Nonparticipating Manufacturer’s
Quantity
Total Cigarettes
Quantity
Total Cigarettes
Packs of 20
Name
Name & Address
(Col c. X 20)
Packs of 25
(Col. e. X 25)
Total Column d. from additional page(s)
CERTIFICATION: I certify that I am authorized to sign this document and that the
Total Column d.
information contained here is correct to the best of my knowledge.
Date
Printed Name
Signature
Total Column f. from additional page(s)
Total Column f.
GRAND TOTAL Columns d. + f.

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