Form Mt-203-W-T - Transfers And Wholesale Sales Of Tobacco Products Page 4
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4Page 4 of 4 MT-203-W-T (11/10)
Schedule 5 — Transfers and wholesale sales of snuff outside of New York State
C
D
Name and address of business located
Snuff containers of less than one ounce
Snuff containers of one ounce or more
outside of New York State to whom you
EIN of customer
No. of individual
transferred and/or sold product
containers
Selling price
Ounces of snuff
Selling price
A
B
C
25 Total transfers and wholesale sales from this Schedule 5
26 Total transfers and wholesale sales from additional attached sheet(s), if any
27 Total transfers and wholesale sales
(add lines 25 and 26; enter here and on
Form MT-203-W, line 5, columns C and D)
28 Total selling price from this Schedule 5
29 Total selling price from additional attached sheet(s), if any
30 Total selling price
(add lines 28 and 29)
Schedule 6 — Transfers and wholesale sales of little cigars outside of New York State
E
Name and address of business located
Number of packs of little cigars
outside of New York State to whom you
EIN of customer
No. of individual
transferred and/or sold product
cigars
Selling price
A
B
C
31 Total transfers and wholesale sales from this Schedule 6
32 Total transfers and wholesale sales from additional attached sheet(s), if any
33 Total transfers and wholesale sales
(add lines 31 and 32; enter here and on
Form MT-203-W, line 5, column E)
34 Total selling price from this Schedule 6
35 Total selling price from additional attached sheet(s), if any
36 Total selling price
(add lines 34 and 35)
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