Clear Form
2009
REVENUE USE ONLY
Form
Date received
•
OREGON QUARTERLY TAX RETURN
532
FOR MANUFACTURERS DISTRIBUTING
NONEXEMPT TOBACCO PRODUCTS
Quarter dates
Due date
Program code
Year
Period
Liability
Payment received
•
•
•
•
•
532
09
1
Federal identification no.
Quarter
Oregon business identification no.
Business name:
•
Mailing address:
City:
State:
ZIP:
Please use blue or black ink when filling out this form.
Type of business:
Corporation
Partnership
Individual
Other: ________________________
•
1. Number of cigars at wholesale price of 77 cents or more .........................1
2. Multiply the number of cigars by 50 cents (line 1 × 0.50) ............................................................ 2
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3. Wholesale price of cigars at wholesale price of less than 77 cents ..........3
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4. Wholesale price of all other tobacco products ..........................................4
5. Total of lines 3 and 4 ..................................................................................5
6. Multiply line 5 by 0.65 .................................................................................................................. 6
7. Total quarterly tax (add lines 2 and 6) .......................................................................................... 7
8. Quarterly tax discount (multiply line 7 by 0.015) .......................................................................... 8
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9. Net tax due (line 7 minus line 8) ................................................................................................... 9
10. Penalty and interest (see instructions) ....................................................................................... 10
11. Total amount due (add lines 9 and 10) ..................................................................................... 11
DECLARATION
I declare under the penalties for false swearing [ORS 305.990(4)] that I have examined this document and to the best of
my knowledge it is true, correct, and complete.
Signature
Social Security no.
Date
PRINT name signed above
Title
Telephone number
(
)
150-605-005 (Rev. 12-08)
Please read the instructions