Form Cg-32 - Manufacturer'S Sample Product Cigarette Tax Return

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KANSAS DEPARTMENT OF REVENUE
MISCELLANEOUS TAX – CUSTOMER RELATIONS
915 SW HARRISON ST.
TOPEKA, KANSAS 66612-1588
Web site:
Email: miscellaneous.tax@kdor.ks.gov
Phone: (785) 368-8222
Fax: (785) 291-3968
MANUFACTURER’S SAMPLE PRODUCT
CIGARETTE TAX RETURN
________________________________________, a manufacturer, has given ________________ free samples
(Name of Business)
(Number of Packs)
away in the state of Kansas for the month and year of _________________________.
(Month, Year)
Number of Packs
X
$ 0.79
Tax Rate
0.00
$
Amount of Tax Due
__________________________________________
______________________________
(Signature)
(Date)
__________________________________________
______________________________
(Title)
(Phone Number)
Submit this form to:
Miscellaneous Tax
Customer Relations
915 SW Harrison Street
Topeka, Kansas 66612-1588
CG-32
(Rev. 6/13)

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