Schedule F (Form Cg-5.5/6.5) - Sales Of Cigarettes Exceeding 6,000 Cartons

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CG-5.5/6.5
New York State Department of Taxation and Finance
Schedule F — Sales of Cigarettes Exceeding 6,000 Cartons
(5/05)
Transaction and Transfer Tax Bureau FACCTS/Cigarette Tax
Attach this schedule to your cigarette tax report, Form CG-5 or CG-6, for March, June, September, and December.
Name of agent
Federal employer identification number (FEIN)
Filed with report for the calendar
Month:
Year:
List below the name, address, and FEIN of each of your customers to whom 6,000 cartons of cigarettes or more have been sold
or otherwise disposed of during any one of the preceding three months. Enter the total number of cigarette cartons sold to each
customer during the entire three-month period.
Column A
Column B
Column C
Number of cartons containing
Type of business
wholesaler, retailer,
Name, address, and FEIN of customer
other
(explain)
Packs of 20 cigarettes
Packs of 21 - 25 cigarettes
Instructions for Schedule F
Tax period and taxpayer identification
Enter your legal name, your federal employer identification number (FEIN), and the month and year of the period covered by this schedule.
Column A — Enter the name, address, and federal employee identification number (FEIN) of each of your customers to whom 6,000 or more
cartons of cigarettes were sold or otherwise disposed of during any one of the preceding three months.
Column B — Enter each customer’s type of business (wholesaler, retailer, or other). If other than a wholesaler or retailer, explain in detail.
Column C — For each customer, indicate by pack size, the total number of cartons you sold them during the preceding three-month period.
Attach this schedule to Form CG-5, Nonresident Agent Cigarette Tax Report, or Form CG-6, Resident Agent Cigarette Tax Report.
Attach additional sheets if necessary

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