Form Sd Eform - 1788 V7 - Wholesalers Quarterly Tobacco Shipment Report - South Dakota Department Of Revenue & Regulation

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SD EForm -
1788
V7
Complete and use the button at the end to print for mailing.
HELP
SOUTH DAKOTA DEPARTMENT OF REVENUE & REGULATION
WHOLESALERS QUARTERLY TOBACCO SHIPMENT REPORT
Reporting Period:
___January 1, through March 31, ______
___April 1, through June 30, ______
(Check one)
Due April 20
Due July 20
___July 1, through September 30, ______
___October 1, through December 31, ______
Due October 20
Due January 20
South Dakota License Number: _____________________Business Telephone Number __________________________
Business Name: ___________________________________________________________________________________
Business Address: _________________________________________________________________________________
Mailing Address (if different from above): ________________________________________________________________
City, State, Zip: ____________________________________________EIN/SSN Number: _________________________
Email Address: ____________________________________________________________________________________
LIST RYO INFORMATION:
A
B
C
D
E
Brand Name
NPM Name and
Supplier Name and
RYO Ounces
RYO Ounces
Address
Address
you paid SD
SD taxes were
Taxes On
already PAID
I swear under penalty of perjury that this report is, to the best of my knowledge and belief, true, correct and complete.
Name of Preparer (please type or print):_______________________________________Date: _____________________
Signature of Preparer: ______________________________________Telephone Number: ________________________
ATTACH DOCUMENTATION. SEE INSTRUCTIONS.
CLEAR FORM
PRINT FOR MAILING

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