Form Rc-50-Inv - Report Of Cigarette Stamp Inventory As Of June 23, 2012

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Illinois Department of Revenue
RC-50-Inv
Report of Cigarette Stamp Inventory as of June 23, 2012
Step 1:
Identify your business
1
Business name: ____________________________________
3
Account ID: ______________ - ______________
2
Address: __________________________________________
4
License no.: _______________________________________
_________________________________________________
Step 2:
Report your June 23, 2012, ending inventory
Pack Size
Column A
Column B
20 cigarettes
25 cigarettes
per pack
per pack
5
Write the number of unaffixed Illinois stamps.
_____________
_____________
6
Write the number of packs with affixed Illinois stamps to be returned to the manufacturer. _____________
_____________
7
Write the number of affixed Illinois stamps (do not include the amounts
accounted for in Line 6).
_____________
_____________
8
Add Lines 5, 6, and 7 of each column.
_____________
_____________
Step 3:
Sign below
Under penalties of perjury, I state that I have examined this report and, to the best of my knowledge, it is true, correct, and complete.
_______________________________________________________
______________________________________________________
Signature (taxpayer’s or paid preparer’s)
Date
Title (if applicable)
_______________________________________________________
______________________________________________________
Signature (Department of Revenue representative, if witnessed)
Taxpayer’s phone number
Form RC-50-Inv is due with your Form RC-50, 2012 Cigarette Floor Stock Tax Return.
Note: You must complete and return both forms even if you do not owe any floor tax.
Return both forms to:
ALCOHOL, TOBACCO AND FUEL DIVISION
ILLINOIS DEPARTMENT OF REVENUE
PO BOX 19018
SPRINGFIELD IL 62794-9018
If you have questions, call 217 782-6045.
This form is authorized by the Cigarette and Cigarette Use Tax Acts. Disclosure of this information is REQUIRED. Failure to comply may
result in a penalty. This form has been approved by the Forms Management Center.
RC-50-Inv (N-6/12)

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