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2012
REVENUE USE ONLY
Form
Date Received
OREGON QUARTERLY TAX RETURN
531
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FOR TOBACCO PRODUCTS
Payment Received
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(Other than Licensed Distributor)
Quarter dates
Due date
Social Security no.
Business ID no.
Program
Year
Period
Liability
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•
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531
12
1
/
/
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Federal Identification No.
Quarter
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Name: ____________________________________________________________________
Check if address, name change,
or entity change
Mailing address: ___________________________________________________________
Check if this is an amended
return
City: _______________________________________ State: ____ ZIP: ______________
Check if correspondence is
included
Please use blue or black ink when filling out this form.
, not like this: (
) . NO COMMAS!
Print numbers like this:
, not like this:
. Enter negative numbers like this: –
You are a(n):
Individual
Partnership
Corporation
Other: ____________________________________________
SECTION 1—All Tobacco Products Tax (excluding moist snuff, chewing tobacco, and cigars)
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1. Wholesale price of untaxed tobacco products (Schedule 1A) ...................................................................1
2. Tobacco products tax (multiply line 1 by 0.65) .................................................................................... 2
SECTION 2—Moist Snuff (Definition A) Tax on Units at or Below Floor
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3. Total number of units (1.2 oz or less) of untaxed moist snuff (definition A) at or below floor (Schedule 2A) .... 3
4. Moist snuff (definition A) tax on units at or below floor (multiply line 3 by $2.14) ............................... 4
SECTION 3—Moist Snuff (Definition A) Tax on Units Above Floor
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5. Total ounces of untaxed moist snuff (definition A) above floor (Schedule 3A) ................................... 5
6. Moist snuff (definition A) tax on units above floor (multiply line 5 by $1.78) ...................................... 6
SECTION 4—Moist Snuff (Definition B) Tax on Units at or Below Floor
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7. Total number of units (1.2 oz or less) of untaxed moist snuff (definition B) at or below floor (Schedule 4A).... 7
8. Moist snuff (definition B) tax on units at or below floor (multiply line 7 by $2.14) ............................... 8
SECTION 5—Moist Snuff (Definition B) Tax on Units Above Floor
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9. Total ounces of untaxed moist snuff (definition B) above floor (Schedule 5A) ................................... 9
10. Moist snuff (definition B) tax on units above floor (multiply line 9 by $1.78) .................................... 10
SECTION 6—Cigar Tax on Cigars Subject to Cap (cigars purchased for 77¢ or more each)
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11. Total number of untaxed cigars subject to cap (Schedule 6A) ......................................................... 11
12. Tax on cigars subject to cap (multiply line 11 by $0.50) ................................................................... 12
150-605-006 (Rev. 12-11)