Schedule C-1 - Tobacco Products Tax - Record Of Moist Snuff Sold, Used, Or Distributed In A Non-Taxable Manner

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State of New Jersey - TPWST
Division of Taxation
(1/09)
Schedule C-1
Revenue Processing Center
Tobacco Products Tax
PO Box 280
Trenton, NJ 08646-0280
Record of Moist Snuff Sold, Used, or Distributed in a Non-Taxable Manner
NOTE: PROVIDE ONLY SUMMARY DATA BY CUSTOMER ON THIS SCHEDULE.
Name
___________________________________________________________
Period Ending (Month/Year) __________/__________
Address _____________________________________________________
FEIN _______________________________________
Enter the total of Schedule C-1 on line 9 of the Tobacco Products Tax Return. Attach Schedule C-1 to the return.
Column 1
Column 3
Column 2
Explanation of Non-Taxable Sales
Customer Name and Address
Number of Ounces
Enter this amount on Line 9 of the Tobacco Products Tax Return.
Total
Make Additional Copies Of This Form If Necessary to Report The Required Information

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