Instructions For Form Tt-115 - Tobacco Products Sales To Returns From Authorized Tribal Retailers - 2013 Page 2

TT‑115: Tobacco Products Sales To/Returns From Authorized Tribal Retailers

(Schedule to Form TT-100)

Page

of

Legal Name

Tax Account Number

Month/Year (MM YYYY)

Column A

Column B

Column C

Column D

Invoice

Retailer Location

Tobacco Products Tax

Cigar

Moist

Total Tax

Name of

Authorized

Line

Retailer

Tribe

Street Address and City

(not including tax on

Tax

Snuff Tax

(Col. A + B + C)

No.

Number

Date

cigar and moist snuff)

Balance from prior page of Form TT-115. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

Total – Add lines 1 through 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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TT-115 (R. 12-13)

Wisconsin Department of Revenue