Form Cig 58 - Ohio Cigarette Tax Return Page 2

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CIG 58
For lines 11 through 23, use stick totals. Note: Out-of-state wholesalers start on line 22.
Rev. 3/09
Page 2
11. Opening cigarette inventory unstamped (from line 17 of the previous period’s return)
12. Opening cigarette inventory stamped (from line 18 of the previous period’s return)
13. Unstamped cigarettes purchased from manufacturers/importers (from Ohio form CIG 59)
14. Cigarettes purchased from wholesalers (from Ohio form CIG 59A)
15. Cigarettes returned by customers
16. Total to be accounted for (add lines 11, 12, 13, 14 and 15)
17. Closing cigarette inventory unstamped
18. Closing cigarette inventory stamped
19. Exempt sales (from Ohio form CIG 95)
20. Returned to manufacturer
21. Total accounted for (add lines 17, 18, 19 and 20)
22. Sales without liability (from Ohio form CIG 96)
23. Sales with liability (line 16 minus lines 21 and 22)
24. Tax rate
$ .0625
25. Tax liability (line 22 times line 24)
$
26. Ohio stamps used (add lines 10, State column, and 10A)
$
27. State defi ciency (line 25 minus 26)
$
Cuyahoga County return only:
1. Cuyahoga County stick sales
2. Tax rate
$ .01725
3. Tax liability (line 1 times line 2)
$
4. Cuyahoga County stamps used (add line 10, County column, and line 10B)
$
5. Cuyahoga County defi ciency (line 3 minus line 4)
$
Amount paid (line 27 plus Cuyahoga County section line 5)*
$
*Note: Overages on either line 27 or line 5 (Cuyahoga County-only section) may not be used to offset defi ciencies.
I declare under penalties of perjury that this return, including any accompanying schedules and statements, has been examined
by me and to the best of my knowledge and belief is a true, correct and complete return and report.
Signature
Title
Date
Please print cigarette account number on remittance and make payable to the Ohio Treasurer of State. Mail with check
or money order covering tax defi ciency to Ohio Department of Taxation, P.O. Box 530, Columbus, OH 43216-0530.

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