Form Cg-7.1 - Schedule D-1 - Sale Of Cigarettes To Registered Reservation Dealers/nation Or Tribal Businesses

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New York State Department of Taxation and Finance
CG-7.1
Schedule D-1
(8/97)
Sale of Cigarettes to Registered Reservation Dealers/Nation or Tribal Businesses
Transaction and Transfer Tax Bureau - FACCTS/Cigarette Tax
Attach this schedule and the white copy of all tax exemption coupons to your Form CG-5, Nonresident Agent
Filed with return for the calendar
Cigarette Tax and Prepaid Sales Tax Return, or Form CG-6, Resident Agent Cigarette Tax and Prepaid Sales Tax Return
Month of
, 19
Name
Federal identification number
Street address
Agent license number
City
State
ZIP code
New York State sales tax identification number
Social security number
List below all sales of cigarettes to registered reservation dealers/nation or tribal businesses
Dealer/Business Registration
Total Number of Nontaxable
Total Number of
Total Number of
Number (Include nation or
Cigarettes Sold (sticks) (Attach
Name and Address of
Taxable Cigarettes Sold
Taxable and Nontaxable
Tribe exempt organization
white copies of tax exemption
Dealer/Business
(sticks)
Cigarettes Sold
number, if applicable)
coupons to substantiate these sales)
10’s
20’s
25’s
Misc.
10’s
20’s
25’s
Misc.
10’s
20’s
25’s
Misc.
*
*
*
*
Totals
* Enter this amount on Form CG-5, line 7 or Form CG-6, line 9.

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