Schedule A-3 - Tobacco Products Tax For A Resident Distributor

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SCHEDULE A-3
SCHEDULE A-3
SCHEDULE A-3
SCHEDULE A-3
SCHEDULE A-3
STATE OF CONNECTICUT
DEPARTMENT OF REVENUE SERVICES
TOBACCO PRODUCTS TAX - RESIDENT DISTRIBUTOR
Snuff tobacco products activity report
(Rev. 07/00)
(Total of Schedule A-3 must be reported on Line 9 of Form OP-300, Tobacco Products Tax Return )
Schedule A-3 must be attached to Form OP-300
Name ___________________________________________________
Period Ending __________________
CT Tax Registration Number _________________________
Address __________________________________________________________________________________________________________________________________________
Purchased, Imported, Received or
Weight Each
Total Weight
Tax
Acquired From
Invoice Number
Date
Brand Name
Quantity
(in ounces)
(Col. 5x6)
(Col. 7 x 0.40)
1
2
3
4
5
6
7
8
1.
Schedule A-3 SUBTOTAL
(
)
List the amount reported on Schedule C-1 (you must attach a copy of Schedule C-1 to Schedule A-3)
2.
Subtract Line 2 from Line 1. This amount must be reported on Line 9 of Form OP-300
TOTAL
3.

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