Form 16-1-A - Unstamped Cigarettes Purchased - Oklahoma Tax Commission

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Oklahoma Tax Commission
Form 16-1-A
Revised 9-2011
Unstamped Cigarettes Purchased
Name of Firm:
Month of:
,
Address:
City:
State:
Zip:
Number of
Number of
Invoice
Packages
Packages
Shipped From
Date
Number
Purchased From
20’s
25’s
Notice: List by company and each company in date sequence.

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