Form Ct203 - Cigarette Use Tax Return
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4CT203
Cigarette Use Tax Return
Due the 18th day of the month following the month of purchase.
Name
Social Security Number
Address
City
State
ZIP Code
Period of Return (mo/yr)
Figure the tax you owe
1 Total number of cigarettes purchased (from CT203-A, line 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Total number of little cigars purchased less than 3 pounds per thousand (from CT203-A, line 2) . 2
3 Add lines 1 and 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Number of exempt cigarettes and/or little cigars less than 3 pounds per thousand
(can’t be more than 200; see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5 Subtract line 4 from line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
6 Mill rate for cigarettes and little cigars less than 3 pounds per thousand (see instructions) . . . . . . 6
7 Multiply line 5 by line 6
7
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8 Total number of little cigars purchased 3 to 4.5 pounds per thousand (from CT203-A, line 3). . . . . 8
9 Number of exempt little cigars 3 to 4.5 pounds per thousand
(can’t be more than 200; see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
10 Subtract line 9 from line 8. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
11 Multiply line 10 by 0.17950 (mil rate on little cigars 3 to 4.5 pounds per thousand) . . . . . . . . . . . 11
12 Cigarette Tax, Health Impact Fee, and Cigarette Sales Tax (add lines 7 and 11). . . . . . . . . . . . . 12
Figure the non-settlement cigarette/little cigar fee you owe
13 Total number of cigarettes purchased subject to fee (see instructions) . . . . . . . . . . . . . . . . . . . . . . 13
14 Total number of little cigars purchased (from CT203-A, add lines 2 and 3) . . . . . . . . . . . . . . . . . . . 14
15 Add lines 13 and 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
16 Fee mil rate for cigarettes and little cigars (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
17 Cigarette/little cigar fee due (multiply line 15 by line 16) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Figure the total amount you owe
18 Penalty, if any (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
19 Interest, if any (see instructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
20 Total due (add lines 12, 17, 18 and 19) Make check payable to Minnesota Revenue . . . . . . . . . 20
I declare that this form is correct and complete to the best of my knowledge and belief.
Signature
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. 1/17)
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