Form Cig-57 - Ohio Cigarette Consumer'S Use Tax
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1
2Cigarette Tax Form
CIG-57 (Rev. 7/02)
P.O. Box 530
Columbus, OH 43216-0530
Ohio Cigarette Consumer’s Use Tax
R.C. 5743.32 provides that every person who has acquired cigarettes
Reporting Period
for use, storage or other consumption in this state shall, on or before the
15th day of the month following receipt of such cigarettes, make and
file with the Tax Commissioner a return showing the amount of ciga-
rettes acquired, together with remittance of the tax thereon; provided
For the month of _________________, 20 ____
that the tax levied in R.C. 5743.02 and 5743.024 has not been paid.
Instructions
Line 1 – This line should include cigarettes shipped into all areas of Ohio except Cuyahoga County (see reverse side for a
listing of municipalities in Cuyahoga County).
Line 2 – This is the Ohio tax rate.
Line 3 – Multiply line 1 by line 2. This is the tax due on the cigarettes shown on line 1.
Line 4 – This line should include cigarettes shipped into Cuyahoga County.
Line 5 – This is the combined Ohio/Cuyahoga County tax rate.
Line 6 – Multiply line 4 by line 5. This is the tax due on the cigarettes shown on line 4.
Line 7 – Add lines 3 and 6. This amount is the total tax due. Make your check payable to the Treasurer of State of Ohio.
1. Total number of cigarettes shipped into Ohio during report period
_________________
x
.0275
2. Tax rate
_________________
3. Tax liability (line 1 x line 2)
_________________
4. Total number of cigarettes shipped into Cuyahoga County
x
.02975
5. Tax rate
_________________
6. Tax liability (line 4 x line 5)
_________________
7. Total due with this report (add lines 3 and 6)
_________________
I declare under penalties of perjury that this return (in-
cluding any accompanying schedules and statements)
has been examined by me and, to the best of my knowl-
Signature
edge and belief, is a true, correct and complete return
and report.
Title
Date
Mail report and check or money order covering tax due to the Fuel Use and Excise Tax Unit, P.O. Box 530,
Columbus, OH 43216-0530.
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