Form 4345 - C-108m Manufacturer Schedule Of Cigarette Sales (Disbursements)

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Michigan Department of Treasury
4345 (Rev. 04-10)
C-108M: Manufacturer Schedule of Cigarette Sales (Disbursements)
Important: Read the instructions on Page 2 before completing this schedule.
1. Name
2. Account Number (FEIN, TR or ME Number)
3. Michigan License Number
4. Reporting Period (MM/CCYY)
Non-Participating Manufacturer Product
19. Total
Sold To Information
Address of Purchaser
Manufacturer
Brand
14. Pack
5. Date
6. Invoice
7. Invoice
8. Branch
Cigarettes per
Size
Sold
Date
Number
Code
12. City
9. FEIN
10. Name
13. State
15. FEIN
16.Name
17. Code
18. Name
11. Type
entry
20. TOTAL

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