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Page 4 of 4 CG-15 (9/04)

Schedule A and Schedule B

purchases on your personal income tax return or file Form ST-140,

Complete Schedule A if the New York State cigarette tax has not been

Individual Purchaser’s Report of Sales and Use Tax. You must remit

paid on cigarettes purchased or otherwise acquired for use in the state.

payment of the difference between the amount of sales tax paid (if any) on

the purchase of the cigarettes and the amount of sales tax properly due on

Complete Schedule B if the city of New York cigarette tax has not been

the use of the item in this state. When determining the amount of use tax

paid on cigarettes purchased or otherwise acquired for use in New York

(which is equivalent to sales tax) to be paid with Form ST-140 or your

City.

personal income tax return, the state excise tax (i.e., the state cigarette tax

If both the New York State and city of New York use taxes are due on the

or the state cigarette use tax) and, if applicable (for use within

New York City), the New York City excise tax (i.e., the city cigarette tax or

same package of cigarettes, complete Schedule A and Schedule B for

the city cigarette use tax) must be included in the cost of the item before

such cigarettes.

calculating the amount upon which the use tax (sales tax equivalent) is

If more than one purchase is made on the same date from the same

computed.

source, make a separate listing for each. Attach additional sheets if

necessary.

If you are required to file a personal income tax return, the sales and use

tax liability due on these cigarettes is paid with your personal income tax

Attach a copy of the purchase invoice (or any other documents

return. Generally, a personal income tax return, including remittance for any

available) to substantiate your entries.

sales and use tax liability, is due on April 15. However, if you are requesting

an extension of time to file your personal income tax return and you owe

Column A — Enter the date of use (for example, the date the cigarettes

sales and use tax, you must pay any sales or use tax you owe at the time

were purchased or otherwise acquired).

you request the extension. See Form IT-370 for more information. If you

receive an automatic extension of time to pay your New York State personal

Column B — Enter the name and address of the supplier from whom you

income tax (e.g., you are in a foreign country), your sales and use tax is

purchased or otherwise acquired the cigarettes.

due when your New York State personal income tax return is due.

Column C — Enter the brand name of the cigarettes.

If you are not required to file a personal income tax return, you must report

Column D — Mark an X in the appropriate box to indicate whether or not

and pay the sales and use tax liability by filing Form ST-140. Form ST-140

the cigarettes were a mail order.

is due when the federal income tax return would be due, generally April 15

(without regard to any extension of time to file, and without regard to

Column E — Indicate how the cigarettes were used. For example, for

whether a federal income tax return is required to be filed).

self-use or to be given as a gift.

Privacy notification

Column F — Enter the number of standard packages containing 20

cigarettes per pack.

The Commissioner of Taxation and Finance may collect and maintain

Column G — Enter the number of nonstandard packages, as computed to

personal information pursuant to the New York State Tax Law, including but

an equivalent number of packages containing 20 cigarettes, by using the

not limited to, sections 171, 171-a, 287, 308, 429, 475, 505, 697, 1096,

Conversion calculation on page 2.

1142, and 1415 of that Law; and may require disclosure of social security

numbers pursuant to 42 USC 405(c)(2)(C)(i).

Column H — Total number of standard packages. Add the number of

cigarette packages in Column F and Column G.

This information will be used to determine and administer tax liabilities and,

when authorized by law, for certain tax offset and exchange of tax

information programs as well as for any other lawful purpose.

Computation of use tax

Line 1 — Enter the total number of packages of cigarettes used in

Information concerning quarterly wages paid to employees is provided to

New York State from Schedule A, Column H.

certain state agencies for purposes of fraud prevention, support

enforcement, evaluation of the effectiveness of certain employment and

Line 2 — No entry required (lists the current New York State use tax rate

training programs and other purposes authorized by law.

imposed on cigarettes in standard packages of 20 cigarettes).

Failure to provide the required information may subject you to civil or

Line 4 — Enter the total number of packages of cigarettes used in

criminal penalties, or both, under the Tax Law.

New York City from Schedule B, Column H.

This information is maintained by the Director of Records Management and

Line 5 — No entry required (lists the current New York City use tax rate

Data Entry, NYS Tax Department, W A Harriman Campus, Albany NY

imposed on cigarettes in standard packages of 20 cigarettes).

12227; telephone 1 800 225-5829. From areas outside the United States

and outside Canada, call (518) 485-6800.

Line 8 — For failure to pay any tax due, the penalty is 50% of the tax due

for the first month or part of the month, plus 1% of the tax due for each

month thereafter.

Need help?

In addition, failure to file the required returns or to pay any tax due under

Article 20 of the Tax Law may result in the imposition of criminal penalties

Internet access:

under Article 37 of the Tax Law.

(for information, forms, and publications)

Line 9 — Interest is computed at the rate set by the Commissioner of

Taxation and Finance and is compounded daily. Interest is computed from

Fax-on-demand forms:

1 800 748-3676

the date the tax was due until the date the tax is paid. Interest is a charge

for the use of state funds and may not be waived. If you require assistance

Telephone assistance is available from 8:00

to 5:00

A.M.

P.M.

in the computation of interest, call the tax information number listed below.

(eastern time), Monday through Friday.

Payment

To order forms and publications:

1 800 462-8100

Make your check or money order payable to: Commissioner of

Business Tax Information Center:

1 800 972-1233

Taxation and Finance.

From areas outside the U.S. and outside Canada:

(518) 485-6800

Attach your remittance and the photocopies of the purchase invoices to

Hearing and speech impaired (telecommunications device for the deaf

the return and mail to: NYS Tax Department, Cigarette Tax, TTTB

(TDD) callers only): 1 800 634-2110 (8:00

to 5:00

eastern time).

A.M.

P.M.

FACCTS - R & B Unit, Building 8, W A Harriman Campus,

Persons with disabilities: In compliance with the Americans with

Albany NY 12227.

Disabilities Act, we will ensure that our lobbies, offices, meeting

rooms, and other facilities are accessible to persons with disabilities.

When to file and remit payment for a sales and use tax

If you have questions about special accommodations for persons

liability

with disabilities, please call 1 800 972-1233.

If you purchase cigarettes without paying the New York State and/or local

sales tax, or if you purchase cigarettes and pay an amount of sales tax that

is less than the combined sales tax rate of the New York State taxing

jurisdiction where the cigarettes are to be used, you must report these

Form Cg-15 - Cigarette Use Tax Return - New York State Department Of Taxation And Finance Page 4

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