Form Cig 59 - *dealer'S Monthly Report Of Unstamped Cigarette Purchases Received From Licensed Manufacturers Or Importers In Ohio During

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CIG 59
Department of
Rev. 3/09
Reset Form
Taxation
P.O. Box 530
Columbus, OH 43216-0530
*Dealer’s Monthly Report of Unstamped Cigarette Purchases Received From
Licensed Manufacturers or Importers in Ohio During
20
(Month)
Wholesaler name
Ohio cigarette tax account no.
Address
Street
City
State
ZIP code
Report of Unstamped Cigarettes Received from a Manufacturer/Importer
1
3
4
5
6
7
8
2
Name of
Name of
Name of
Name of
Date
Name of
Name of
received
manufacturer/importer
manufacturer/importer
manufacturer/importer
manufacturer/importer
manufacturer/importer
Invoice number
manufacturer/importer
(000)
(000)
(000)
(000)
(000)
(000)
(000)
(000)
(000)
(000)
(000)
(000)
(000)
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Page total
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(000)
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Summary total
(000)
(000)
(000)
(000)
(000)
(000)
Enter grand total of all unstamped purchases on page 1.
Unstamped purchases grand total:
Page
of

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