Form Rev 82 2090 - Tax Declaration For Cigarettes

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WARNING:
To protect against the possibility of others accessing your confidential
information, do not complete these forms on a public workstation.
OFFICE USE ONLY
TRN
Tax Declaration for Cigarettes
Period/Year
Reset This Form
Step 1 - Enter your name and address
Address Changes? Check box and write your corrected address below.
Middle Initial
Last Name (Please Print)
First
Street Address (Include Apartment Number)
City
State
Zip Code
Telephone Number
Step 2 - To avoid duplicate billing, please provide the purchase information.
Company Name
Month of Purchase(s)
Invoice number(s)
Step 3 - Determine Location Code and Use Tax Rate, enter on line 5 (See page 2 for complete instructions)
To determine the location code(s) and tax rate(s), use our
Geographic Information System (GIS)
located on our website at
For further instructions, please see page 2.
Step 4 - To calculate taxes due, please follow the steps below.
Line #
Code
Tax Rate
Tax Due
1. Cigarette Tax:
(287)
Number of cartons
x
$20.25
=
0.00
2. Enter the amount of Tax Due from Line 1
0.00
3.
Total amount paid
(include Shipping & Handling)
+
4.
Add lines 2 & 3 to calculate the total
$0.00
Taxable Amount for sales/use tax
enter the amount from line 4
Location Code
Total Tax Rate
5.
Sales/Use Tax Owed
(05)
x
=
$0.00
$0.00
(46)
(Step 3 from above)
(enter the amount as
a decimal - i.e.: 0.084)
$0.00
6. TOTAL - CIGARETTE AND USE TAX DUE (add Tax Due from lines 1 & 5)
Step 5 - Payment Information
Make check payable to:
Department of Revenue
DUE DATE:
Mail declaration and check to:
Department of Revenue
Taxes are due within
PO Box 47464
72 hours of possession
Olympia, WA 98504-7464
Signature
Print This Form
Date
For tax assistance visit or call 1-800-647-7706. To inquire about the availability of this document in an alternate format for
the visually impaired, please call (360) 705-6715. Teletype (TTY) users may call 1-800-451-7985.
Make a Copy for Your Records
REV 82 2090
(06/06/07)
CIG/JEN

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