Form 4257 - Attach To Your Michigan Wt-100 Or At-100 Forms (Page 2 of 2) in pdf

Form 4257, page 2

Instructions for Completing Form 4257,

T-103: Schedule of Out-of-State Other Tobacco Product Shipments (Michigan Based Licensees Exports Only)

This schedule along with the return must be filed each

Column 11. Enter the two-digit code indicating the

3. Penalty is 5% of tax due if not more than 2 months late

type of business you sold to. Visit

with an additional 5% penalty for each additional month

month by all Michigan Licensed Wholesalers and

Unclassified Acquirers of Other Tobacco Products. A

tobaccotaxes to obtain the codes.

or fraction of month late. Maximum penalty 25%.

return must be filed even if you do not have any tax due.

Column 12. Enter the city that the company that

Assembling Your Return for Mailing

purchased the tobacco products is located in.

How to Complete This Schedule

Assemble the supporting schedules that you attach to your

Column 13. Enter the state that the company that

Check the appropriate box to indicate the schedule type.

return (WT-100 or AC-100) in ascending numerical order

purchased the tobacco products is located in.

Only mark one schedule type per form. Use a single

(i.e. T-101, T-102, etc.).

Column 14. Enter the wholesale price which is defined

line for each transaction or invoice. In some instances

Record Keeping

as the actual price paid for the tobacco product including

an invoice may be recorded more than once if there is

any tax, excluding any discounts.

You must keep a complete copy of your return and all

more than one manufacturer’s product on the invoice.

records pertaining to your business for at least four years.

Complete columns 15 through 19 only if the roll-your-

Invoices that contain NPM’s product must be recorded by

own that you are reporting is manufactured by a non-

The records must be kept in a place and manner easily

each brand purchased from the NPM. Invoices that have

accessible for review by department representatives.

participating manufacturer.

more than one NPM Brand of Roll-Your-Own must have

Column 15. Enter the Federal Employer Identification

Assistance

a separate line entry to report each different brand name.

Number, TR or ME Number of the NPM.

You may contact the Tobacco Taxes Unit by phone at

Schedule Descriptions

Column 16. Enter the Name of the NPM.

(517) 636-4630, by Fax at (517) 636-4631, or by e-mail at

Column 17. Enter the Non-participating manufacturer’s

Schedule T-103: This schedule is to be used to record all

treas_tobaccotaxes@michigan.gov. The mailing address

Other Tobacco Products for sale or transfer in another

three-digit brand code for Roll-Your-Own that can

is Michigan Department of Treasury, Special Taxes

state.

be obtained from our Web site

Division, Tobacco Taxes, P.O. Box 30474, Lansing, MI

Line 1. Enter your business name as it appears on the

tobaccotaxes.

48909-7974. Information and forms are available online

tobacco tax license.

Column 18. List each brand of the NPM’s Roll-Your-Own

at tobaccotaxes.

Line 2. Enter the account number (FEIN, TR or ME

that was sold on a separate line for each invoice number.

License Cancellation

Number) that appears on your tobacco tax license.

Some invoices may be recorded more than once.

Column 19. Enter the total weight of Roll-Your-Own sold

Line 3. Enter the license number from your state of

See instructions on WT-100, AT-100 or ST-100.

Michigan Tobacco Products License.

for each manufacturer’s brand.

Name/Address/Ownership Changes

Line 4. Enter the tax period for which you are reporting.

Column 20. Enter total Premium Cigar Stick Count.

See instructions on WT-100, AT-100 or ST-100.

Line 21. Total the wholesale price column and carry over

(i.e. 01/2005). Schedule Type: Select the appropriate

Mailing Address

schedule type. (Choose one). Indicate the name of the

to WT-100, AT-100, or ST-100.

state the tobacco was transferred to.

Line 22. Total the ounces column.

Mail completed return and schedules with the appropriate

Line 23. Total Premium Cigar Stick Count.

payment to:

Column 5. Enter the date the tobacco products were

shipped to an out-of-state customer.

Michigan Department of Treasury

Due Date

Column 6. Enter the date on the invoice.

P.O. Box 77628

Your return is due 20 days after the close of the month. To

Column 7. Enter the invoice number

Detroit, MI 48277

be timely filed, a return must be postmarked on or before

Enter the branch code if you have more

Column 8.

the 20th of the month following the reporting period.

than one location that submits its tax information under

Late filed Returns

the same account number. The branch code is the State

of Michigan License number assigned to the branch.

Returns which are not timely filed are subject to the

following statutory charges:

Column 9. Enter the federal employer identification

number of the company that you sold the tobacco to.

1. No tax due return $10.00 a day up to $400.00.

Column 10. Enter the name of the person whom the

2. Interest on tax due accrues at 1% above current prime

rate; adjusted on 1/1 and 7/1 each year.

product was sold to.

Form 4257 - Attach To Your Michigan Wt-100 Or At-100 Forms Page 2

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