Form Ct-139w - Wisconsin Retail Cigarette Inventory Tax Return - 2009
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WISCONSIN RETAIL CIGARETTE INVENTORY TAX RETURN
Form CT-139W
DUE SEPTEMBER 30, 2009
Name
Permit Number (for DOR use only)
DBA
Wisconsin Seller’s Permit Number
Address (number and street)
Federal Employer ID Number (if applicable)
City
State
Zip Code
Social Security Number (if sole proprietor)
CIGARETTE INVENTORY TAX COMPUTATION SCHEDULE
Take inventory as of midnight on August 31, 2009. Count all unsold cigarettes regardless of where stored, including
unsalables. Enter only one retail store inventory per return.
Reasons for filing a zero return:
__
I sell cigarettes, but did not have any cigarette inventory on September 1, 2009.
__
I no longer sell or ever sold cigarettes and had no cigarette inventory on September 1, 2009.
__
My retail cigarette/tobacco products license is for selling tobacco products only. I do not sell cigarettes.
__
The cigarettes are owned by another vendor who is responsible for the inventory tax.
The vendor's four-digit permit number that appears on the vending machine is: (F)CV – ___ ___ ___ ___
If you checked one of the boxes above, do not complete lines 1 through 8.
Col. 1
Col. 2
Col. 3
Col. 4
Cigarettes Inventoried on
Tax Rate
Inventory Tax
Types Of Cartons And Packs
8/31/09 (as of midnight)
Per Carton and Pack
(Col. 2 x Col. 3)
Total cartons of 200 cigarettes
1
x
7.50
=
(8 packs of 25 cig. and 10 packs of 20 cig. per pack)
Total cartons of 250 cigarettes
2
X
9.375
=
(10 packs of 25 cigarettes per pack)
3
Total individual packs of 20 cig. per pack
x
0.75
=
4
Total individual packs of 25 cig. per pack
x
0.9375 =
5
Total inventory tax due (add lines 1 through 4 in Column 4).
6
Late-filing fee – For returns filed after September 30, 2009, enter $10.00
7
Interest – For returns filed after September 30, 2009, see instruction for line 7 on the back of this form
8
TOTAL AMOUNT DUE (add lines 5, 6, and 7)
DECLARATION: I declare under penalties of law that I have examined the above information and, to the best of my knowledge and
belief, it is true, correct, and complete.
Retailer Signature (or authorized agent)
Preparer's Name (please print or type)
Preparer's Telephone Number
Date
(
)
Make your check or money order payable and mail with your return to: Wisconsin Department of Revenue
CT-139W (R. 7-09)
Mail Stop 5-107
Post Office Box 8900
Madison, WI 53708-8900
DO NOT pay by using electronic funds transfer (EFT)
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