Form Ct-211 - Cigarette Stamp Order Form - 2000
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1MINNESOTA Department of Revenue
CT-211
Cigarette Stamp Order Form
Orders received after 1:30 pm will be processed the next business day.
Check one:
Ship via
Call or fax to order
Pick-up time
Please give at least one hour notice.
Phone: (651) 297-1882 or
For morning pick-up, order by 9:30 am. For afternoon pick-up, order by 11:00 am
(800) 657-3618
Name
Minnesota tax ID number
TTY:
(800) 627-3529
Minnesota Relay Service
Name of business
Fax:
(651) 297-1939
Address
City
State
Zip code
Phone
Fax
(
)
(
)
Order #:
Stamp serial #
20s
Quantity
Total # of stamps
begin
end
Regular rolls x 30,000 =
Cases x 750,000 =
Boxes x 30,000 =
Pads x 1,500 =
Wide boxes x 30,000 =
Wide pads x 1,500 =
25s
Quantity
Total # of stamps
Rolls x 7,200 =
Pads x 1,500 =
Boxes x 30,000 =
10s
Quantity
Total # of stamps
Pads of 10s x 1,500 =
Native American
Quantity
Total # of stamps
Rolls x 30,000 =
Pads of 20s x 1,500 =
Pads of 25s x 1,500 =
(5/00)
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