Form Ct-115 - Wisconsin Stamped Cigarette Sales To / Return From Authorized Native American Retail Stores Page 2
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2CT-115 INSTRUCTIONS
WHO MUST COMPLETE THIS SCHEDULE
Madison Office Location
2135 Rimrock Road
This schedule must be completed by all cigarette distribu-
Madison, WI 53713
tors who sell stamped cigarettes to retail stores authorized
to sell cigarettes by federally recognized Native American
Mailing Address
Indian Tribes occupying reservation/trust lands in Wiscon-
Excise Tax Section 6-107
sin. This schedule should also be used to report stamped
Wisconsin Department of Revenue
cigarettes returned by the authorized tribal retail stores. If
PO Box 8900
cigarettes are sold to authorized tribal retailers, obtain a
Madison WI 53708-8900
letter from the tribe stating the names and addresses of
the tribe’s authorized cigarette retailers File this schedule
Phone: (608) 266-8970
electronically as an attachement to Form CT-100 or CT-
Fax: (608) 261-7049
105 as needed. These forms are located at
E-mail: excise@revenue.wi.gov
wi.gov/html/cigtob1.html.
Web site: wi.gov
SPECIAL STAMPS
COMPLETING THIS FORM
The special distinctive tribal cigarette tax stamps which
Use a single line for each transaction and provide all the
are available from the department for both 20-packs and
information requested. Group sales by authorized retail
25-packs must be affixed to all packs sold to retail stores
store and provide a subtotal for each store. Indicate a
authorized by any federally recognized Native American
subtotal on each page and a grand total on the last page.
Indian Tribe.
Each entry must be stated in terms of single cigarettes.
Do not enter number of packs or cartons.
WHEN TO COMPLETE AND FILE THIS SCHEDULE
Complete this schedule each month that you have transac-
Sales to Authorized Tribal Retailers. For each sale,
tions (sales and/or returns) with an authorized tribal retailer.
indicate the date of the sale, invoice number, tribe’s name,
Attach this schedule to the cigarette tax return that you are
name and address of the authorized retail store purchasing
required to file each month with the department (CT-100 for
the cigarettes, and the number of stamped single cigarettes
in-state permittees or CT-105 for out-of-state permittees).
sold to the authorized store covered by the invoice.
For in-state permittees filing the CT-100, this schedule
Credits (shorts/return of product by tribe). For each
is informational. For out-of-state permittees that file the
entry, indicate the credit memo/invoice number, its date,
CT-105, these sales must also be included on Schedule
tribe’s name, the name and address of the authorized retail
CT-101, Schedule 6, Tax-Paid Sales as part of Wisconsin
store credited, and the number of stamped single cigarettes
sales. Out-of-state permittees should transfer the total on
returned or shorted. Place parenthesis (
) around the
line 30 to their CT-101, Schedule 6, Tax-Paid Sales. Enter
number of cigarettes returned or shorted and deduct this
the total on a line and label it “Tribal sales from CT-115.”
amount when computing the total to enter on line 30.
RECORDS
Line 30 Total. Enter the total net (sales less credits) num-
You must keep a complete copy of your return, including
ber of Wisconsin stamped single cigarettes sold during the
this schedule, and all records pertaining to your business
month to authorized tribal retail stores.
for at least four years. The records must be kept at the
permit location, and in a place and manner easily acces-
COMPUTER PRINTOUTS
sible for review by department representatives.
The department will accept computer printouts of cigarette
transactions in lieu of listing individual sales/returns on this
ASSISTANCE
schedule. If submitting computer listings:
You can access the department’s web site 24 hours a day,
seven days a week, at wi.gov. From this web
1.
Use this form as a summary sheet for the accompany-
site, you can:
ing printouts. Complete the top portion of this form,
indicate “see attached” on line 1, and enter the net
• Complete electronic fill-in forms
total of all Wisconsin tribal sales/returns on line 30.
• Download forms, schedules instructions, and
2.
Prepare your computer printouts using the same
publications
format and columnar sequence as on this form.
• View answers to frequently asked questions
Group sales/returns by retail store on your printout
• E-mail us comments or request help
(if possible) and provide a net total for each store.
• Access My Tax Account
If you are unable to duplicate this format, submit a
proposed format for our review. We will let you know
if it is satisfactory or what changes will be required.
3.
Use paper 8½ X 11 inches.
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