Form Cg-15 - Cigarette Use Tax Return Page 2

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CG-15 (7/10) (back)
Schedule B — New York City
Complete Schedule B if you purchased or otherwise acquired for use in New York City cigarettes in packages that do not have the joint
New York State and New York City tax stamp affixed. Attach additional sheets if necessary.
A
B
C
D
E
F
G
H
Date
Name and address of supplier
Brand name
Mail order
Nature
Number of
Number of
Total
(mark an X in the
of use
of use
standard
nonstandard
packages
appropriate box)
packages
packages
(self-use,
(add columns
gift, etc.)
(20 cigarettes
(see Conversion
F and G)
calculation below)
per pack)
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Total
.......................................................................................................................................
(enter here and on page 1, line 4)
Conversion calculation
The cigarette use tax on Form CG-15 is computed on the basis of a standard package of 20 cigarettes.
For nonstandard packages containing more than 20 cigarettes per pack, use the following calculation to convert the number of
nonstandard packages to an equivalent number of standard packages.
Multiply the number of cigarettes in the nonstandard pack by the number of nonstandard packs. Then divide by 20. Enter the resulting
number of equivalent standard packs in column G of Schedule A on page 1 and/or Schedule B above, as applicable.
Make a separate entry on the schedule(s) for each brand, pack size, and date of use.
Conversion calculation formula
Number of cigarettes per nonstandard pack × number of nonstandard packs
=
number of equivalent standard packs *
20 cigarettes in a standard pack
* Enter this result in Column G of Schedule A and/or Schedule B, as appropriate.
Example:
25 cigarettes per pack × 10 packs
= 250 ÷ 20 = 12.5 standard packs
20
Note: New York State Public Health Law prohibits the sale of cigarettes in packs containing fewer than 20 cigarettes.

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