Form Ct-101 - Wisconsin Cigarette Tax Multiple Schedule

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CT-101: Wisconsin Cigarette Tax Multiple Schedule
Page
of
(File with Form CT-100 or Form CT-105)
IMPORTANT! For reporting purposes, UNSTAMPED cigarettes include cigarettes stamped for other states.
Legal Name
Tax Account Number
Month/Year (MM YYYY)
Type of schedule (check one)
1. Untaxed Purchases
3. Untaxed Credits
5. Untaxed Sales
DISTRIBUTOR PERMITTEES MUST COMPLETE
(Non-Participating Manufacturer’s brands and
2. Tax-Paid Purchases
4. Tax-Paid Credits
6. Tax-Paid Sales
excluded brands of Participating Manufacturers).
Column D
Column A
Column B
Column C
Invoice
Purchased From or Sold To
Line
Invoice Total
No.
Date
Number
Name
State
Single Cigarettes
Single Cigarettes
Manufacturer
Brand Name
Balance brought forward . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Balance brought forward . . . . . . . .
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
Do NOT transfer to
Page Totals - provide a grand total on the last page of each schedule . . . . .
20
CT-100 or CT-105 . . . . . . . TOTAL
Wisconsin Department of Revenue
CT-101 (R. 1-12)

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