Form Ttb F 5300.26 - Federal Firearms And Ammunition Quarterly Excise Tax Return - 2014 Page 2
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2SCHEDULE A — INCREASING ADJUSTMENTS (See instructions)
Amount of Adjustments
Tax
Interest
Penalty
Explanation of Increasing Adjustments
(b)
(c)
(d)
(a)
23.
$
$
$
24.
25.
26. Totals of Columns (b), (c), and (d)
$
$
$
$
27. Total of Item 26, Columns (b), (c), and (d)
SCHEDULE B — DECREASING ADJUSTMENTS (See instructions)
Amount of Adjustments
Explanation: Select an allowable adjustment from the drop-down
(Provide details on row below.)
Tax
Interest
(a)
(b)
(c)
28.
$
$
29.
30.
31.
Conditions to Allowance: In Compliance with 26 U.S.C. 6416(a)(1), I/We certify
Yes
32.
that I/we sold the article(s) at a tax-excluded price, repaid the amount of tax to
the buyer, or have obtained written consent from the buyer to make this/these
No
claim(s)/adjustment(s). (See Instructions)
33. Totals of Columns (b) and (c)
$
$
34. Total of Item 33, Columns (b) and (c)
$
CERTIFICATION
Under penalties of perjury, I declare that I have reported all transactions and tax liabilities required by law and regulations. I have examined
this return (including any attached explanations, statements, schedules, and forms) and to the best of my know ledge and belief it is true,
complete, and correct. If I took adjustment(s) in Schedule B, I have met all requirements of Title 26, United States Code and the applicable
Federal regulations, Title 27, Code of Federal Regulations, Part 53.
35. Date
36. Signature
37. Title
(Original Signature Only)
PAPER CHECK CONVERSION NOTICE TO CUSTOMERS MAKING PAYMENT BY CHECK
If you send us a check, it will be converted into an electronic funds transfer (EFT). This means we will copy your check and use the account
information on it to electronically debit your account for the amount of the check. The debit from your account will usually occur within 24
hours, and will be shown on your regular account statement. You will not receive your original check back. We will destroy your original
check, but we will keep the copy of it. If the EFT cannot be processed for technical reasons, you authorize us to process the copy in place
of your original check. If the EFT cannot be completed because of insufficient funds, we may try to make the transfer up to 2 times.
PRIVACY ACT
A Privacy Act Statement required by 5 U.S.C. 552a(e)(3) stating our authority for soliciting and collecting the information from your check,
and explaining the purposes and routine uses w hich w ill be made of your check information, is available at
system-records.pdf, or call toll free at (877) 882-3277 to obtain a copy by mail. Furnishing the check information is voluntary, but a decision
not to do so may require you to make payment by some other method.
TTB F 5300.26 (12/2014)
Previous editions are obsolete
Page 2 of 6
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