Form 522 - Cigarette And Tobacco Products Monthly Tax Return - State Of Alaska Page 5
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8522
Schedule G
Alaska Tobacco Products Transactions
Do not report cigarettes here. Use Schedule F to report cigarettes.
Federal ID
License Number
Name of Licensee
Period Ending (yyyymm)
You must complete this schedule if you manufactured, imported, acquired or sold tobacco products (other than cigarettes) in the state
during the month covered by this return. Use a separate schedule for each type of transaction that applies to your business identified in
boxes A through D below. Use additional pages as necessary. All invoices supporting transactions identified in boxes A through D must
be attached to this schedule to constitute a complete filing.
Check one:
A. Tobacco products manufactured, imported, acquired or sold. Enter on Schedule B, line 6.
B. Credit for military sales. Enter on Schedule B, line 7.
C. Credit for Metlakatla Indian Reservation or Klawock Smoke Shop sales. Enter on Schedule B, line 8.
D. Other credits - Unsaleable or destroyed tobacco products. You must attach an affidavit from the manufacturer or
distributor supporting the amount of tobacco products returned and/or U.S. Treasury Dept. Form ATF-F 5200.7
supporting the amount of tobacco products destroyed. Enter on Schedule B, line 9.
Invoice date
Name of supplier or purchaser
Invoice number
Tobacco products only
TOTALS CARRIED FORWARD FROM PREVIOUS PAGE(S)
Total
Page number
_______
_______
of
522
0405-522 Rev 09/12 - page 5
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