Name: Tax Period: Permit Number: EIN: TB 1301-NP Idaho State Tax CommissionTobacco Master Settlement AgreementIdaho Activity for Nonparticipating Brands of Roll-Your-Own TobaccoUse this schedule to report any taxable roll-your-own tobacco purchased from nonparticipating manufacturers and then sold in Idaho. You must complete this and brands online, go to www2.state.id.us/ag/consumer/tobacco/directoryindex.htm. For more information on the Tobacco Master Settlement Agreement, please visit the Idaho Attorney General222s Web site at www2.state.id.us/ag/consumer/tobacco.htm. a. BrandNamed.Quantity(In Ounces)e.Total Cigarette Equivalent(Col. d. 367 0.09)EFO0014512-16-08 b. Nonparticipating Manufacturer222sName & Address GRAND TOTAL Column e. CERTIFICATION: I certify that I am authorized to sign this document and that the information contained here is correct to the best of my knowledge. Date � Printed Name� Signature Total Column e. from additional page(s) c. SupplierReceived From American LegalNet, Inc. www.FormsWorkFlow.com TB 1301-NP Idaho Activity for Nonparticipating Brands of Roll-Your-Own Tobacco (page 2) Use this schedule to report any additional nonparticipating brands of taxable roll-your-own tobacco sold and brands online, go to www2.state.id.us/ag/consumer/tobacco/directoryindex.htm.EFO0014512-16-08Carry the Total for Column e. to the front page. a. BrandNamed.Quantity(In Ounces)e.Total Cigarette Equivalent(Col. d. 367 0.09) b. Nonparticipating Manufacturer222sName & Address Total Column e. c. SupplierReceived From American LegalNet, Inc. www.FormsWorkFlow.com