Form 4259 - T-101 Schedule Of Other Tobacco Product Purchases (Receipts) Page 2
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24259, Page 2
Instructions for Completing Form 4259,
T-101: Schedule of Other Tobacco Product Purchases (Receipts)
This schedule along with the return must be filed each month
Column 10. Enter the name of the company whom you obtained
Assembling Your Return for Mailing
the tobacco from.
by all Michigan Licensed Wholesalers, Secondary Wholesalers,
Assemble the supporting schedules that you attach to your
and Unclassified Acquirers of Other Tobacco Products (OTP). A
Column 11. Enter the 2 digit code indicating the type of business
return (WT-100, AT-100, or ST-100) in ascending numerical
return must be filed even if you do not have any tax due. To report
you obtained from. Visit for
order (i.e. T-101, T-102, etc.).
cigarette purchases, use schedule C-101 a-d.
a list of the codes.
Record Keeping
How to Complete This Schedule
Column 12. Enter the city that the company that you obtained
You must keep a complete copy of your return and all records
the tobacco from is located in.
Check the appropriate box to indicate the schedule type. Only
pertaining to your business for at least four years.
The
Column 13. Enter the state that the company that you obtained
mark one schedule type per form. Use a single line for each
records must be kept in a place and manner easily accessible
the tobacco from is located in.
transaction or invoice. In some instances an invoice may be
for review by department representatives.
Column 14. Enter the wholesale price which is defined as
recorded more than once if there is more than one manufacturer’s
Assistance
product on the invoice. Invoices that contain NPM’s product must
the actual price paid for the tobacco product including any tax,
be recorded by each brand purchased from the NPM. Invoices
excluding any discounts.
You may contact the Tobacco Taxes Unit by phone at (517)
that have more than one NPM Brand of Roll-Your-Own must have
636-4630, by Fax at (517) 636-4631, or by e-mail at treas_
Complete columns 15 through 19 only if the roll-your-own
a separate line entry to report each different brand name.
tobaccotaxes@michigan.gov.
The mailing address is
that you are reporting is manufactured by a non-participating
Michigan Department of Treasury, Special Taxes Division,
Schedule Descriptions
manufacturer.
Tobacco Taxes, P.O. Box 30474, Lansing, MI 48909-7974.
Column 15. Enter the Federal Employer Identification Number,
Schedule T-101a: This schedule is to be used to record all tax-
Information and forms are available online at
unpaid OTP purchases that were acquired in Michigan.
TR or ME Number of the NPM.
gov/tobaccotaxes.
Column 16. Enter the Name of the NPM.
Schedule T-101b: This schedule will be used by wholesalers and
License Cancellation
secondary wholesalers only to record all tax paid OTP purchased
Column 17. Enter the Non-participating manufacturer’s three-
See instructions on WT-100 or AT-100.
from another licensee.
digit brand code for Roll-Your-Own that can be obtained from our
website .
Schedule T-101c: This schedule is to be used to record all tax
Name/Address/Ownership Changes
paid OTP returned by Michigan Customers.
Column 18. List each brand of the NPM’s Roll-Your-Own that
See instructions on WT-100 or AT-100.
was obtained on a separate line for each invoice number. Some
Line 1. Enter your business name as it appears on the tobacco
Mailing Address
invoices may be recorded more than once.
tax license.
Mail completed return and schedules with the appropriate
Column 19. Enter the total weight of Roll-Your-Own obtained for
Line 2. Enter the account number (FEIN, ME or TR Number) that
payment to:
each manufacturer’s brand.
appears on your tobacco tax license.
Column 20. Enter total Premium Cigar Stick Count.
Line 3. Enter the license number from your state of Michigan
Michigan Department of Treasury
Tobacco Products License.
Line 21. Total the wholesale price column and carry over to WT-
P.O. Box 77628
100, AT-100, or ST-100.
Line 4. Enter the tax period for which you are reporting. (i.e.
Detroit, MI 48277
01/2005).
Line 22. Total the ounces column.
Schedule Type: Select the appropriate schedule type. (Choose
Line 23. Total Premium Cigar Stick Count.
one).
Due Date
Column 5.
Enter the date the OTP were received by your
Your return is due 20 days after the close of the month. To be
business.
timely filed, a return must be postmarked on or before the 20th of
Column 6. Enter the date on the invoice.
the month following the reporting period.
Column 7. Enter the invoice number
Late filed Returns
Column 8.
Enter the branch code if you have more than one
Returns which are not timely filed are subject to the following
location that submits its tax information under the same account
statutory charges:
number. The branch code is the State of Michigan License
1. No tax due return $10.00 a day up to $400.00.
number assigned to the branch.
2. Interest on tax due accrues at 1% above current prime rate;
Column 9. Enter the federal employer identification number of
adjusted on 1/1 and 7/1 each year.
the company that you obtained the tobacco from.
3. Penalty is 5% of tax due if not more than 2 months late with
an additional 5% penalty for each additional month or fraction of
month late. Maximum penalty 25%.
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