Tax Declaration For Other Tobacco Products (Page 2 of 2) in pdf

Tax Declaration For Other Tobacco Products Page 2

Tobacco Definitions:

Smoking Tobacco

Smokeless Tobacco

Cigars, cheroots, stogies, periques, cigarillos, cigars,

Snuff, snuff flour, Cavendish, plug and twist

blunts, pipe tobacco, cigarette tobacco and other

tobacco, finecut, chewing tobacco and other

tobacco products that are consumed primarily by

tobacco products that are consumed primarily

smoking

by chewing, but not by smoking

Purchases made on or after July 1, 2009:

Schedule A – Smoking Tobacco

Invoice Date

Seller

Product/Quantity Purchased

Price $

Total Schedule A (Enter total $ on line 1)

Schedule B – Smokeless Tobacco in Consumer Retail Containers weighing less than 1 ounce

Invoice Date

Seller

Product

# Containers

Price $

Total Schedule B (Enter total number < 1 oz Containers and $ on line 4)

Schedule C – Smokeless Tobacco in Consumer Retail Containers weighing 1 ounce or more

Invoice Date

Seller

Product

# Ounces

Price $

Total Schedule C (Enter total Ounces and $ on line 5)

If you have questions or need assistance with this form, call (207) 624-9609 between the hours of 8:00am

and 5:00pm weekdays, except Holidays, e-mail us at

fuel.tax@maine.gov

or visit the Maine Revenue

Services website at:

Reproduce as Necessary

Last Revised 11/30/2010

Tax Declaration For Other Tobacco Products Page 2