Form Ct-1 - Vermont Wholesale Cigarette Dealer Report
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1Vermont Department of Taxes PO Box 547 Montpelier, VT 05601-0547
Phone: (802) 828-2551, option 4
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orm
VERMONT WHOLESALE CIGARETTE DEALER REPORT
V
ermont
CT-1
This report is due on or before the 15th of each month to cover the preceding month.
Dealer’s Name
Federal ID Number
Address
Month
Year
City, State, ZIP Code
State License Number
E-mail address
Telephone Number
PART A - STAMP INVENTORY
HEAT TRANSFER STAMPS USED
VERMONT STAMPS
20-packs
25-packs
1. Stamps on hand at beginning of month . . . . . . . . . . . . . . . . . . . . . 1. __________________ ________________
2. Stamps purchased during the month . . . . . . . . . . . . . . . . . . . . . . . 2. __________________ ________________
3. Total (Add Lines 1 and 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. __________________ ________________
4. Stamps affixed during the month . . . . . . . . . . . . . . . . . . . . . . . . . . 4. __________________ ________________
5. Stamps on hand at end of month . . . . . . . . . . . . . . . . . . . . . . . . . . 5. __________________ ________________
DETAIL OF STAMPED PRODUCT
6. Number of packs of cigarettes stamped during the month . . . . . . 6. __________________ ________________
7. Number of packs of little cigars stamped during the month . . . . . 7. __________________ ________________
PART B - TAX DUE
NONSTAMPED LITTLE CIGARS
8. Enter the number of INDIVIDUAL little cigars sold in Vermont during
the month (Do NOT enter the number of packages sold) . . . . . . . . . . . . . . . . . . .8._________________________
9. Tax due for nonstamped little cigars (Multiply Line 8 by .131) . . . . . . . . . . . .9. ________________________
ROLL-YOUR-OWN TOBACCO
10. Number of ounces of roll-your-own tobacco sold in Vermont during the month 10._________________________
11. Equivalent number of cigarettes (Divide Line 10 by .0325) . . . . . . . . . . . . . . . .11._________________________
12. Tax due for roll-your-own tobacco (Multiply Line 11 by .131) . . . . . . . . . . . .12._________________________
TAX DUE
13. TOTAL TAX DUE (Add Lines 9 and 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13._________________________
Make checks payable to Vermont Department of Taxes.
Signature
I hereby swear, under pains and penalty of perjury, that this information is true, correct, and complete to the best
of my knowledge.
Signature
Title
Date
Printed Name
For assistance, please call (802) 828-2551, option 4
Form CT-1
CT
Rev. 05/11
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