Form M-19 - Cigarette And Tobacco Products Monthly Tax Return Page 4

Download a blank fillable Form M-19 - Cigarette And Tobacco Products Monthly Tax Return in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form M-19 - Cigarette And Tobacco Products Monthly Tax Return with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

FORM M-19 (REV. 2011)
PAGE 4
Name
Cigarette Tax and Tobacco Tax License Number
Month Ending
__ __ / __ __
(MM/YY)
PART II - REFUND OF CIGARETTE TAX PAID WITH CIGARETTE TAX STAMPS
CONTINUED
MCF114
SCHEDULE 5 — REFUND FOR DAMAGED CIGARETTE TAX STAMPS AFFIXED TO CIGARETTE PACKAGES
Proof of damaged cigarette tax stamps shall be offered for inspection and examination at any time upon request of the Department of Taxation or the
Department of the Attorney General. See instructions.
5. Number of cigarette tax stamps that were damaged while being affixed to the cigarette packages
x $3.20 =
$
6. Total refund of cigarette tax paid with cigarette tax stamps. Add lines 1, 2, 3a, 3b, 4, and 5. Enter total here and on page 1, line 23 $
PART III - SCHEDULE OF CIGARETTE BRANDS SOLD
List the cigarette brand, cigarette brand style, and number of cigarettes sold (both wholesale and retail sales) during the month:
Cigarette Brand
Cigarette Brand Style
Number of Cigarettes Sold
Total Number of Cigarettes Sold
PART IV - SCHEDULE OF CIGARETTES SOLD, USED, AND POSSESSED
CIGARETTES
TOTAL WHOLESALE VALUE
1.
Number of cigarettes sold at wholesale during the month ............................................
$
1
2.
Number of cigarettes sold at retail during the month .....................................................
$
2
3.
Number of cigarettes used during the month subject to the tax ....................................
$
3
4.
Total number of cigarettes sold and used during the month (add lines 1, 2, and 3) ......................................................
4
5.
Less non-taxable sales (Number of cigarettes from page 2, Part I, Non-Taxable Sales of Cigarettes) .........................
5
6.
Total taxable cigarettes (line 4 minus line 5) ..................................................................................................................
6
PART V - CIGARETTE TAX STAMPS INVENTORY
Caution: See instructions before completing Part V.
YELLOW STAMPS
LIGHT GRAY STAMPS
1.
Number of cigarette tax stamps on hand at beginning of the month .......................................
2.
Number of cigarette tax stamps purchased during the month .................................................
3.
Number of cigarette tax stamps transferred in during the month ............................................
4.
Add lines 1, 2, and 3 ................................................................................................................
5.
Number of cigarette tax stamps affixed to cigarette packages during the month ....................
6.
Number of cigarette tax stamps transferred out during the month ..........................................
7.
Number of unused cigarette tax stamps returned for a refund during the month ....................
8.
Add lines 5, 6, and 7 ................................................................................................................
9.
Number of cigarette tax stamps on hand at end of the month (line 4 minus line 8) ................

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 4