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CG-5.4/6.4 (3/14) (back)

Instructions

General information

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Except for sales to the Oneida Nation of New York, all

packages of cigarettes sold to Indian nations or tribes

Visit our Web site at

or reservation cigarette sellers are required to have New

• get information and manage your taxes online

York tax stamps affixed to them. However, these stamped

• check for new online services and features

packages of cigarettes will be exempt from the tax to

the extent Indian tax exemption coupons are received

Telephone assistance

or prior approval is granted by the Tax Department and

Miscellaneous Tax Information Center: (518) 457-5735

the cigarettes are delivered or brought onto a qualified

reservation. See TSB-M-10(6)M, Amendments to the Tax

To order forms and publications:

(518) 457-5431

Law Related to Sales of Cigarettes on Indian Reservations

Text Telephone (TTY) Hotline (for persons with hearing

Beginning September 1, 2010.

and speech disabilities using a TTY): If you have

access to a TTY, contact us at (518) 485-5082.

All packages of cigarettes sold to the Oneida Nation of

If you do not own a TTY, check with independent

New York must be reported on Part 2 of Form CG-5.2,

living centers or community action programs to find

Schedule C — Sales and Transfers of Unstamped Cigarettes

out where machines are available for public use.

Within New York State, or Part I(B) of Form CG-6.3,

Persons with disabilities: In compliance with the

Schedule D — Sales, Transfers, and Returns of Unstamped

Americans with Disabilities Act, we will ensure

Cigarettes Within New York State, whichever applies.

that our lobbies, offices, meeting rooms, and other

facilities are accessible to persons with disabilities. If

Who must file this schedule

you have questions about special accommodations

for persons with disabilities, call the information

You must file Form CG-5.4/6.4, Schedule E, if you are a

center.

New York State cigarette agent who has sold cigarettes

to Indian nations or tribes or reservation cigarette sellers

located on qualified Indian reservations within New York

State.

A copy of Schedule E must be attached to Form CG-6,

Resident Agent Cigarette Tax Report, or Form CG-5,

Nonresident Agent Cigarette Tax Report, that you are

required to file on or before the 15th day of the month

following the month being reported.

Tax period and taxpayer identification

Enter your legal name and your federal employer

identification number (FEIN).

Enter the month and year of the period covered by this

schedule.

Name and address of purchaser

Enter the name and address of each purchaser and the

name of the qualified Indian reservation within New York

State to whom you sold cigarettes during the period

covered by the report. For each purchaser listed, indicate

their FEIN, social security number, or nation’s or tribe’s

exempt organization number, if applicable. List the

coupon number(s) of the Indian tax exemption coupon(s)

received from the purchaser or the prior approval reporting

confirmation number(s) for each sale. In addition, list the

number of cigarettes (sticks) sold to each dealer or business

for each pack size.

Note: The total number of cigarettes allowed per coupon

cannot exceed 6,000 cigarettes.

Schedule E (Form Cg-5.4/6.4) - Sale Of Cigarettes To Indian Nations Or Tribes Or Reservation Cigarette Sellers Page 2

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