Form Ct401-Lc - Little Cigars Stamped

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CT401-LC
Little Cigars Stamped
Check if amended:
Little cigars reported on this schedule should not be reported on CT401-B, CT401-C, or CT401-I .
Licensee
FEIN
Street
Minnesota Tax ID Number
Check if New Address
City
State
ZIP Code
Period of Return (mo/yr)
Number of Little Cigars Stamped (less than 3lbs per thousand)
A
B
C
Number of
Total number
Brand
sticks per pack
Number of packs
of sticks (multiply A by B)
1
Line 1 Totals (add column B and column C for all brands) . . . . . . . . . . . . . . . . . . . 1b
1c
2 Tax due (multiply line 1c by 0.18070) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3 Total tax paid (multiply line 1b by 3.614) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Net tax/credit (subtract line 3 from line 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Number of Little Cigars Stamped (3lbs to 4.5lbs per thousand)
A
B
C
Number of
Total number
Brand
sticks per pack
Number of packs
of sticks (multiply A by B)
5
Line 5 Totals (add column B and column C for all brands) . . . . . . . . . . . . . . . . . . . 5b
5c
6 Tax due (multiply line 5c by 0.18070) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
7 Total tax paid (multiply line 5b by 3.614) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
8 Net tax/credit (subtract line 7 from line 6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
9 TOTAL TAX/CREDIT (add lines 4 and 8; enter the amount here and on CT401, line 11) . . . . . . . . . . . . . . . . . . . 9
I declare that this return is correct and complete to the best of my knowledge and belief.
Authorized Signature
Title
Date
Daytime Phone
Mail to Minnesota Revenue, Mail Station 3331, St. Paul, MN 55146-3331.
Phone: 651-556-3035. Email: cigarette.tobacco@state.mn.us
(Rev. 1/18)

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