Form Rc-11 - Schedule Ce - Sales Of Cigarettes And Little Cigars To Licensed Illinois Distributors

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Illinois Department of Revenue
REV 01 FORM 442
RC-11
Schedule CE
Sales of Cigarettes and Little Cigars to Licensed Illinois Distributors
Read this information first
Sheet no. __________
As a distributor, you must report on this schedule all sales of cigarettes or little cigars you made to other Illinois licensed
distributors (this includes out-of-state distributors with a valid Illinois license) on which you did not pay the Illinois Cigarette Tax.
Attach two copies of this schedule to Form RC-6, Cigarette and Little Cigar Revenue Return, and retain one copy.
For additional instructions, see Form RC-6.
Step 1: Identify your business
Name _ ____________________________________________
Account ID __ __ __ __ __ __ __ __
Address ___________________________________________
License no. C - ___ ___ ___ ___ ___
Number and street
__________________________________________________ Tax period __ __ / __ __ __ __
City
State
ZIP
Month
Year
Step 2: Identify your sales
FEIN of
Name of distributor to
Address of distributor to whom
Date
Invoice no.
distributor to whom
whom you shipped
you shipped cigarettes or
Number of sticks
you sold cigarettes
cigarettes or
little cigars
or little cigars
or little cigars
,
,
,
_ _/_ _/_ _ _ _
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Page total
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*344211110*
Grand total
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RC-11 (R-07/13) Schedule CE
This form is authorized as outlined under the tax or fee Act imposing the tax or fee for which this form is filed. Disclosure of this
information is required. Failure to provide information may result in this form not being processed and may result in a penalty.

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