Form Ct201-B - Minnesota Distributors Credit For Returned Cigarettes

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CT201-B
Attachment #4
Minnesota Distributors
Page
of
Credit for Returned Cigarettes
Licensee
Address
Minnesota tax ID number
Period of return (mo/yr)
Enter number of cigarettes (not packs or cartons) returned to the manufacturer . Report cigarettes during month of return, not
the month credit memo is received .
Credit for Non-Fee Brands
Credit memo
RGA
A
B
Manufacturer
Other-state stamped
Unstamped
Date
Number
number*
1
2
3
4
5
6
7
8
9
10 Total non-fee cigarettes (add lines 1 through 9) . . . . . . . . . . . . . . . . . . . . . . . 10
Enter on CT201-R, line 13A
Enter on CT201-R, line 14A
Credit for Fee Brands
Credit memo
RGA
A
B
Manufacturer
Other-state stamped
Unstamped
Date
Number
number*
11
12
13
14
15
16
17
18
19
20 Total fee cigarettes (add lines 11 through 19) . . . . . . . . . . . . . . . . . . . . . . . . . 20
Enter on CT201-R, line 13B, and
Enter on CT201-R, line 14B, and
on CT201-F, line 8
on CT201-F, line 9
21 Total other-state stamped cigarettes (add lines 10A and 20A) . . . . . . . . . . . . 21
Enter on CT201-R, line 13C
22 Total unstamped cigarettes (add lines 10B and 20B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Enter on CT201-R, line 14C
* Returned Goods Authorization (RGA) number.
(Rev . 1/12)

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