Form 605-A (Schedule A) - Maryland Cigarette Tax
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1FORM
MARYLAND
Page: _____________ of ______________
SCHEDULE A
605-A
CIGARETTE
Month or Period: ___________ 20 ______
TAX
License No.: ________________________
DISTRIBUTOR’S NAME
ADDRESS
CIGARETTE PACKS RECEIVED FROM
DURING MONTH OR PERIOD
(Indicate Name of Manufacturer)
Unit
Unit
Unit
FOR OFFICE USE ONLY
Date
Invoice
Actually
Delivered by (Carrier)
Packs
Packs
Packs
Number
TAB RUN
S/B
CK or DIFF.
VOUCHER
AMOUNT
Received
20’s
25’s
Other (
)
TOTAL
For more information:
Visit our Web site at or call Taxpayer Service at 410-260-7980 in Central Maryland or 1-800-638-2937 from elsewhere. Send faxes to 410-260-7924.
Mail to: Comptroller of Maryland, Revenue Administration Division, P.O. Box 2999, Annapolis, MD 21404-2999.
COM/RAD-605-A
Revised 02/13
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