Form Rc-10 - Schedule Cd - Out-Of-State Cigarette Sales Or Shipments With Instructions (1998)

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Illinois Department of Revenue
Schedule CD
Out-of-State Cigarette Sales or Shipments
• Complete a separate schedule for each state into which you shipped or sold cigarettes. This includes cigarettes you returned to manufacturers.
• Attach two copies of this schedule to either Form RC-6, Cigarette Revenue Return, or Form RC-6-A, Out-of-State Cigarette Revenue Return.
State into which you shipped cigarettes ____________________________________________________________________
Date __ __ __ __/__ __ __ __
Month
Year
Name _______________________________________________________________________________________________
FEIN __ __ - __ __ __ __ __ __
DBA _______________________________________________________________________________________________
SSN __ __ __ - __ __ - __ __ __ __
Street address ________________________________________________________________________________________
Cig. license no. ___________________
City, state, ZIP ________________________________________________________________________________________
Your state’s account no._____________
See the back of this schedule for detailed instructions on completing Columns 1 through 9.
1
2
3
4
5
6
7
8
9
How
Invoice
Name and address of person
# of packs # of packs
Other
No. of cigarettes Tax paid
Date
shipped number
to whom cigarettes were shipped or sold
(20’s)
(25’s)
(specify)
(total sticks)
(yes/no)
__/__/__ _______ _______ __________________________________________________________ _________ _________ _________ ______________ _______
__/__/__ _______ _______ __________________________________________________________ _________ _________ _________ ______________ _______
__/__/__ _______ _______ __________________________________________________________ _________ _________ _________ ______________ _______
__/__/__ _______ _______ __________________________________________________________ _________ _________ _________ ______________ _______
__/__/__ _______ _______ __________________________________________________________ _________ _________ _________ ______________ _______
__/__/__ _______ _______ __________________________________________________________ _________ _________ _________ ______________ _______
__/__/__ _______ _______ __________________________________________________________ _________ _________ _________ ______________ _______
__/__/__ _______ _______ __________________________________________________________ _________ _________ _________ ______________ _______
__/__/__ _______ _______ __________________________________________________________ _________ _________ _________ ______________ _______
__/__/__ _______ _______ __________________________________________________________ _________ _________ _________ ______________ _______
__/__/__ _______ _______ __________________________________________________________ _________ _________ _________ ______________ _______
Subtotal: This page only
_________________________
Grand total
_________________________
RC-10 front (R-4/98)
This form is authorized by the Illinois Cigarette Tax and Cigarette Use Tax acts. Disclosure of this information is REQUIRED. Failure to comply may result in a penalty. This form has been approved by the Forms Management Center. IL-492-1506

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