Monthly Report By Resident Wholesale Dealers In Cigarette Products - Alabama Department Of Revenue Page 2

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PART II – Cigarette Products Actually Purchased And Received During The Month
CIGARETTES ONLY
INVOICE
INVOICE
* MANUFACTURER/
FROM WHOM PURCHASED AND RECEIVED
(a)
(b)
DATE
NUMBER
DISTRIBUTOR NUMBER
(NAME AND ADDRESS)
NUMBER OF
TAX VALUE
CIGARETTES
(Col. a x $0.02125)
T P
T P
T P
T P
T P
T P
T P
T P
T P
T P
T P
T P
T P
T P
T P
T P
T P
T P
T P
T P
T P
T P
T P
T P
T P
TOTALS (Enter here and also Part I, line 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
* This is the eight character number assigned to the manufacturer (or other distributor) by the Alabama Department of Revenue. A listing of
numbers may be obtained from our website at If a company’s name and
manufacturer/distributor number is not listed, contact the Tobacco Tax Section at 334/242-9627.
Copy and attach additional sheets if needed. A computer printout with the EXACT headings and this format is acceptable; however, totals
must be entered on this page. We can no longer accept return information, including schedules, not in the EXACT format as this form.

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