EW1
Pounds of Video Display Devices Sold to Households During
the Period July 1, 2015, Through June 30, 2016
Schedule A
You must report the total weight of each model of video display devices (VDDs) you sold to Minnesota households during the previous pro-
gram year. You can report the actual total weight (Option 1) OR estimate the total weight of VDDs you sold nationwide during the reporting
period (Option 2). You must explain how you calculated the actual or estimated weight.
Business Name
Minnesota Tax ID Number
Federal ID Number (FEIN)
Minnesota Sales (Option 1)
Retailer
Brand/Model
Pounds per Model X
Number Sold
=
Weight
1 Total weight of Minnesota sales
Enter amount on Form EW1, line 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
National Sales (Option 2)
Brand/Model
Pounds per Model X
Number Sold
=
Weight
1 Total weight of national sales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Multiply line 1 by 1.72% (0.0172), which is Minnesota’s percentage of the national population
Enter amount on Form EW1, line 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
How did you calculate the actual weight or estimated weight of VDDs?
Send in this schedule with Form EW1.