Ets Form 140 - Cigarette Wholesaler'S Monthly Report - 1999 Page 2

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Printed Name:
Telephone No:
Date: ________________
Calculation of Cigarette Taxes Due:
1. Enter the Grand Total of 25-Cigarette Packages Sold During the Month
2. Multiplication Factor (2.82 cents per package)
0.0282
3. Tax Due on 25-Cigarette Packages
This report is due on or before the 20th day of the month following the tax period indicated above.

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