Form Ttb F 5000.28t09 - Floor Stocks Tax Return - Tobacco Products And Cigarette Papers And Tubes 2009

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OMB No. 1513-0129 (09/30/2009)
DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
2009 FLOOR STOCKS TAX RETURN -
Tobacco Products and Cigarette Papers and Tubes
(See Instructions and complete ages 1 & 2)
SECTION I – TAXPAYER IDENTIFYING INFORMATION
1.
NAME AND ADDRESS
2.
EMPLOYER IDENTIFICATION NUMBER (EIN)
3.
NUMBER OF LOCATIONS WHERE INVENTORY
WAS TAKEN FOR THIS RETURN
4.
CONTROLLED GROUP STATUS (Check one)
I am not a member of a controlled group. (A controlled group is any group of corporations or non-incorporated businesses that have common
ownership interests. Generally, a business is considered to be part of a controlled group if more than 50 percent of the business is either
owned by, or in common with, another business.) (For complete definition, see 26 U.S.C. 5061(e)(3) and 26 U.S.C. 1563)
I am a member of a controlled group and I am attaching a list of all members of my controlled group
(List the location, EIN and each member’s portion of the floor stocks tax credit).
SECTION II – CALCULATION OF TAXES
FLOOR
STOCKS TAX
COMPUTED TAX
INVENTORY AS OF
CONVERSION
Column (b) x (c)
APRIL 1, 2009
ARTICLE
RATE
(a)
(b)
(c)
(d)
5. SMALL
IGARETTES
$0.03083
$
cigarettes
(Weight: 3 lbs. or less per 1,000)
6. LARGE
IGARETTES*
$0.06474
$
cigarettes*
(Weight: more than 3 lbs. per 1,000)
7. SMALL
IGARS
$
cigars
$0.048502
(Weight: 3 lbs. or less per 1,000)
8. LARG
IGARS
LARGE CIGARS ARE EXEMPT FROM FLOOR STOCKS TAX
(Weight: more than 3 lbs. per 1,000)
9. CHEWING
OBACCO
$0.3083
$
pounds
(Round to nearest hundredth (2 decimals))
10. SNU
$0.925
$
pounds
(Round to nearest hundredth (2 decimals))
11. PIPE TOBACCO
$
pounds
$1.7342
(Round to nearest hundredth (2 decimals))
12. ROLL-YOUR
WN TOBACCO
$
pounds
$23.6831
(Round to nearest hundredth (2 decimals))
13. CIGARETTE PAPERS**
$
units**
$0.0193
(Record units of 50 papers and fraction thereof)
14. CIGARETTE TUBES**
$
$0.0386
units**
(Record units of 50 tubes and fraction thereof)
15. TOTAL (Add Items 5(d) through 14(d).)
$
16. TAX CREDIT (Up to $500. Your tax credit cannot exceed the amount due.) If you file more than one
$
return you may claim only one tax credit. If you are a member of a controlled group, the group may
claim only one tax credit totaling no more than $500.
17. TOTAL TAX DUE (Subtract Line 16 from Line 15) File this return even if your net tax liability is zero.
$
Page 1 of 3
TTB F 5000.28T09 (0 /2009)

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