Schedule C-1 - Tobacco Products Tax - Resident Distributor
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1SCHEDULE C-1
SCHEDULE C-1
SCHEDULE C-1
SCHEDULE C-1
SCHEDULE C-1
STATE OF CONNECTICUT
TOBACCO PRODUCTS TAX - RESIDENT DISTRIBUTOR
DEPARTMENT OF REVENUE SERVICES
Record of snuff tobacco products exported out of Connecticut or sold to the federal government
(Rev. 07/00)
(Total of Schedule C-1 must be carried forward to Line 2 of Schedule A-3, Tobacco ProductsTax - Resident Distributor - Snuff Tobacco Products Activity Report )
Schedule C-1 must be attached to Schedule A-3
Name ___________________________________________________
Period Ending __________________
CT Tax Registration Number _________________________
Address __________________________________________________________________________________________________________________________________________
Weight Each
Total Weight
Tax
Invoice Number
Date
Sold To
Brand Name
Quantity
(in ounces)
(Col. 5x6)
(Col. 7 x 0.40)
1
2
3
4
5
6
7
8
Total must be carried forward to Line 2 of Schedule A-3
TOTAL
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