Az Form 800-20 - Schedule C-1, C-2 - Export Of Participating Manufacturer'S Cigarettes (Except Roll-Your-Own Tobacco), Export Of Nonparticipating Manufacturer'S Cigarettes (Except Roll-Your-Own Tobacco)

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SCHEDULE C-1

AZ FORM 800-20

Schedule C-1

Sheet ___ of ___

Export of Participating Manufacturer’s Cigarettes (except roll-your-own tobacco)

CIGARETTES EXPORTED TO (name of state)

TOBACCO LICENSE NO.

TAXPAYER I.D. NO.

FOR THE PERIOD OF

LEGAL BUSINESS NAME

BUSINESS (OR DBA) NAME

Please see instructions before completing this form. Please provide the following information with respect to all Participating Manufacturer’s cigarettes (excluding roll-your-own

tobacco) that you exported from Arizona. A list of Participating Manufacturers, and their brands authorized for sale in Arizona, is maintained and updated at the Arizona Attorney

General’s web site,

(a)

(b)

(c)

(d)

(e)

(f)

(g)

Participating Manufacturer’s

Purchaser/Transferee -

Tax Paid?

Date

Invoice Number

Name and Address

Brand Family

Packs of 20

(Yes/No)

1 Subtotal: This page only ............................................................................................................................................................................................. 1

2 Balance Forward from Additional Sheets .................................................................................................................................................................... 2

3 GRAND TOTAL: Add lines 1 and 2 ............................................................................................................................................................................ 3

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