Schedule C (Form 4390) - Tobacco Products - Other Than Cigarettes Wholesaler Export Sales Page 2

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MISSOURI DEPARTMENT OF REVENUE
TOBACCO PRODUCTS —
OTHER THAN CIGARETTES
MILITARY SALES — SCHEDULE D
COMPANY
LICENSE NO.
ADDRESS
CITY
STATE
ZIP CODE
___ ___ ___ ___ ___
SALES MADE TO MILITARY INSTALLATIONS WITHIN MISSOURI
YOUR
YOUR
MANUFACTURER’S INVOICE PRICE
TO WHOM SOLD
ADDRESS
INVOICE DATE
INVOICE NUMBER
(BEFORE DISCOUNTS AND/OR DEALS)
_ _ / _ _ / _ _ _ _
$
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
0
Enter total here and on Line 8 of Form 4387 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
FORM 4390 (02-2012)
MISSOURI DEPARTMENT OF REVENUE
TOBACCO PRODUCTS —
OTHER THAN CIGARETTES
SOLD TO ANOTHER MISSOURI LICENSED WHOLESALER — SCHEDULE E
COMPANY
LICENSE NO.
ADDRESS
CITY
STATE
ZIP CODE
___ ___ ___ ___ ___
YOUR
YOUR
MANUFACTURER’S INVOICE PRICE
TO WHOM SOLD
ADDRESS
INVOICE DATE
INVOICE NUMBER
(BEFORE DISCOUNTS AND/OR DEALS)
_ _ / _ _ / _ _ _ _
$
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
_ _ / _ _ / _ _ _ _
0
Enter total here and on Line 9 of Form 4387 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$
FORM 4390 (02-2012)

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