Fillable Form Ct303 - Tobacco Use Tax Return printable pdf download

Form Ct303 - Tobacco Use Tax Return

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CT303

Tobacco Use Tax Return

Use this form to pay tax on tobacco products other than cigarettes .

Name

Social Security number

Address

City

State

ZIP code

Month

Year

Cost

Invoice #

Date

Purchased From

(name/address of person or business)

(before any discount)

Total cost of tobacco purchased

1 Total cost of tobacco purchased . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

2 Exemption (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

3 Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

If line 3 is zero or less, you do not owe tax .

If line 3 is more than zero, continue on line 4 .

4 Tobacco tax and health impact fee (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

5 Penalty, if any (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

6 Interest, if any (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

7 AMOUNT DUE (add lines 4–6)

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Make check payable to Minnesota Revenue

I declare that this form is correct and complete to the best of my knowledge and belief.

Signature

Date

Daytime phone

Mail to: Minnesota Revenue, Mail Station 3331, St . Paul, MN 55146-3331

Phone: 651-556-3035 (TTY: Call 711 for Minnesota Relay) . Email: cigarette .tobacco@state .mn .us

(Rev . 3/12)