Form Tp-102 - Tobacco Product Tax Credit - 2005 Page 2

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Section 2 – Computation of Credit
5. Total add line 1 and line 3 .......................................................................... $ ___________________
6. Tobacco product tax rate.............................................................................
0.50
7. Total tobacco tax paid (multiply line 5 by line 6) ......................................... $ ___________________
8. Total add line 2 and line 4 .......................................................................... ___________________
oz
9. Moist snuff product tax rate .........................................................................
$ 0.85/oz
10. Total moist snuff tax paid (multiply line 8 by line 9) .................................... $ ___________________
11. Total tax paid add line 7 and line 10 ........................................................... $ ___________________
12. Discount rate................................................................................................
0.015
13. Total tobacco product tax discount (multiply line 11 by line 12) ................. $ ___________________
14. Tobacco product tax credit (subtract line 13 from line 11) .......................... $ ___________________
I hereby swear and affirm under penalty of false swearing that the information herein and attachments are true
and correct to the best of my knowledge.
Print Name of Principal or Agent
Date
Signature of Principal or Agent

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