Form Ct501-A - Cigarettes Imported During The Month

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CT501-A
Attachment #1
Minnesota Importers
Cigarettes Imported During the Month
Read instructions on back .
Licensee
Address
Minnesota tax ID number
Period of return (mo/yr)
Page
of
Non-fee brands
Fee brands
A
B
Date
rec’d
Invoice #
Manufacturer
Quantity
Manufacturer
Quantity
Totals from previous page, if any
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19 Total non-fee cigarettes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19A
Total fee cigarettes . . . . . . . . . . . . . . 19B
(if final page, also enter on CT501-R, line 2A)
(if final page, also enter on CT501-R, line 2B)
20 If this is the final page, enter total cigarettes received during the month (add lines 19A and 19B)
Also enter this amount on CT501-R, line 2C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
(Rev . 1/08)

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