Form Tp-12 - Products Sold To Other Distributors/wholesalers
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Illinois Department of Revenue
TP-12
Products Sold to Other Distributors/Wholesalers
Read this information first
Do not write above this line.
Attach this schedule to Form TP-1, Tobacco Products Tax Return, when you claim a deduction on Form TP-1, Line 12, for merchandise sold
to other distributors/wholesalers. If you need to identify more than 14 invoices, additional Forms TP-12 must be completed. You can use our
WebFile program to file your return electronically at tax.illinois.gov. We will accept a computer-generated schedule as long as we approve its
format and content prior to use. To obtain approval, please send a copy of your format to: Office of Publications Management, Illinois Depart-
ment of Revenue, 101 West Jefferson Street, MC 3-375, Springfield, Illinois 62702.
Step 1: Identify your business
1
3
Business name
_____________________________________
Account ID: ____ ____ ____ ____ ____ ____ ____ ____
2
4
TP
Address: _____________________________________________
License no.
– ____ ____ ____ ____ ____
Number and street
5
____________________________________________________
For what month are you filing this schedule?
_______/_______
City
State
ZIP
Month
Year
Step 2: Complete the following information for sales to other distributors/wholesalers
Customer name, address, and FEIN
Reference or
Date
Wholesale price*
invoice number
1 _______________________________________________
_______________ ___/___/___
$____________________
Name
Month Day
Year
_____________________________________________________
Street address
City
State
ZIP
FEIN: ___ ___ - ___ ___ ___ ___ ___ ___ ___
2 _______________________________________________
_______________ ___/___/___
$____________________
Name
Month Day
Year
_____________________________________________________
Street address
City
State
ZIP
FEIN: ___ ___ - ___ ___ ___ ___ ___ ___ ___
3 _______________________________________________
_______________ ___/___/___
$____________________
Name
Month Day
Year
_____________________________________________________
Street address
City
State
ZIP
FEIN: ___ ___ - ___ ___ ___ ___ ___ ___ ___
4 _______________________________________________
_______________ ___/___/___
$____________________
Name
Month Day
Year
_____________________________________________________
Street address
City
State
ZIP
FEIN: ___ ___ - ___ ___ ___ ___ ___ ___ ___
5 _______________________________________________
_______________ ___/___/___
$____________________
Name
Month Day
Year
_____________________________________________________
Street address
City
State
ZIP
Complete back page if more
FEIN: ___ ___ - ___ ___ ___ ___ ___ ___ ___
lines are needed in Step 2.
Step 3: Figure your total
Add the wholesale price of all tobacco products sold to other distributors from all Forms TP-12
$____________________
you are filing for the month listed in Step 1. Transfer this grand total amount to Form TP-1, Step 2, Line 12.
* The wholesale price is the established list price for which a manufacturer sells tobacco products to a distributor. In the absence of an
established list price, the manufacturer's invoice price at which he or she sells the tobacco products to an unaffiliated distributor will be
used as the wholesale price. The wholesale price is the price established before any discount, trade allowance, rebate, or other reduction.
*240401110*
TP-12 (R-12/12)
This form is authorized as outlined by the Tobacco Products Tax Act of 1995. Disclosure of
this information is REQUIRED. Failure to provide information could result in penalties.
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