Schedule A-1 - Tobacco Products Tax - Resident Distributor
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1Department of Revenue Services
State of Connecticut
Schedule A-1
PO Box 5018
Hartford CT 06102-5018
Tobacco Products Tax - Resident Distributor
(Rev. 07/11)
Record of tobacco products excluding snuff tobacco products and cigars in excess of $1.00 per cigar purchased, imported, received, or
acquired in Connecticut.
Name
Period ending
Address
CT Tax Registration Number
Enter the total of Schedule A-1 on Form OP-300, Tobacco Products Tax Return, Line 1. Attach Schedule A-1 to the return.
Wholesale sales price means: In the case of a distributor which is the manufacturer of the tobacco products, the price set for these
products or if no price has been set, the wholesale value of these products; in the case of a distributor that is not the manufacturer of the
tobacco products, the price at which the distributor purchased the products.
Date
Seller’s
Wholesale
Received
From Whom Purchased or Acquired
FEIN
Invoice Number
Sales Price
Total
Enter this amount on Form OP-300, Line 1.
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