Schedule D (Form Otp 10) - Other Tobacco Products
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1OTP 10
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Rev. 4/09
P.O. Box 530
Columbus, OH 43216-0530
Other Tobacco Products Schedule D
(Use additional pages if necessary)
Account number
Name of reporting in-state licensed distributor
Tobacco Products Destroyed With Prior Approval
For the period of
Page
of
Date Approval
Date
Product
Wholesale
Granted
Destroyed
Quantity
Description
Cost
Page total
Grand total
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Parent category: Financial