Form Tb-43 (Schedule 1) - Distributors Tobacco Products Monthly Report

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KANSAS DEPARTMENT OF REVENUE
MISCELLANEOUS TAX
915 SW HARRISON ST.
TOPEKA, KANSAS 66612-1588
Web site:
Email: miscellaneous.tax@kdor.ks.gov
PHONE: (785) 368-8222
FAX: (785) 291-3968
SCHEDULE 1
DISTRIBUTOR’S TOBACCO PRODUCTS MONTHLY REPORT
Name
License Number
Address
Filing Month/Year
Signature of Dealer
1. Tobacco products received during month
1a. All other (Schedule 2)
$
1b. Roll-Your-Own (Schedule 3)
$
1c. Total Tobacco products received during month (Add lines 1a and 1b)
$
Exemptions:
2. Sold to out-of-state customers (Schedule 4)
$
3. Returned to manufacturer (Schedule 4)
$
4. Sold to U.S. Government or Reservations (Schedule 4)
$
5. Total exemptions (Add lines 2, 3 & 4)
$
6. Total taxable tobacco (Subtract line 5 from line 1c)
$
7. Tax liability (Multiply line 6 by 10%)
$
8. Less: Distributor’s compensations (Multiply line 7 by 4%)
$
9. Less: Credit forward from previous months
$
10. Subtotal (Subtract lines 8 and 9 from line 7)
$
11. Penalty (See website for current rates)
$
12. Interest (See website for current rates)
$
13. TOTAL DUE (Add lines 10, 11, and 12)
$
th
This report with all supporting schedules and full remittance is due by the 20
day of the month following the report month.
TB-43
(Rev. 6/13)

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