Mail to: Indiana Department of Revenue P.O. Box 901 Indianapolis, Indiana 46206-0901 INDIANA DEPARTMENT OF REVENUE Cigarette Paper and Tube Tax Return for Out-of-State Distributors For the Period of _________________, _____ Distributor’s License Number _______________ CT16-P SF 48480 7-05 Name of License Holder License Number Address Federal I.D. Number City State Zip Code Telephone Number Part I - Cigarette Paper and Tube Accountability CARTON REQ 1 1 LOOSE PAPERS w/TOBACCO CARTON REQ 3 Indiana Sales - Schedule “CPH” 2 CARTON REQ 2 Closing Inventory Indiana Stamped 3 Total Lines 1 and 2 4 Beginning Inventory Indiana Stamped 5 Purchased Indiana Stamped - Schedule “CPC” 6 Total Lines 4 and 5 7 Quantity Stamped: Line 3 Minus Line 6 8 Tax Rate Per Item Stamped $ .12 $ .24 $ .36 9 Tax Due Per Items Stamped $ $ $ $ .12 Per 1200 Papers $ * 10 Total Tax Due: Add Line 9 All Columns * * $ ***For Loose Papers with Tobacco: Affix Stamps to Back of Return Part II - Stamp Accountability 11 Beginning Inventory of Tax Stamps $ Inv. Date Inv. Date 12 a Add: Purchases During Month b 13 Total Lines 11 and 12 14 Deduct Closing Inventory of Tax Stamps 15 Stamps Used During Month Inv. No. Inv. No. $ No. of Stamps on Hand $ 16 Overage/Shortage: Line 10 Minus Line 15 American LegalNet, Inc. www.FormsWorkflow.com Instructions for Form CT16-P ( Indiana Cigarette Paper and Tube Tax Return) For Out-of-State Distributors Part I – Cigarette Paper and Tube Accountability (Cartons with 1,200 or less papers require 1 stamp, cartons with 1,201 to 2,400 papers require 2 stamps, cartons with 2,401 to 3,600 papers require 3 stamps, loose papers included with tobacco products requires 1 stamp for every 1,200 papers.) Key REQ 1 = Requires 1 stamp REQ 2 = Requires 2 stamps REQ 3 = Requires 3 stamps Line 1 Indiana Sales – Schedule “CPH” – List the number of cartons (by size type) that were sold to customers in Indiana. These figures are carried forward from the totals on Schedule CT-18P – CPH. Line 2 Closing Inventory Indiana Stamped – The number of Indiana stamped cartons (by size type) in inventory at the end of the period. Line 3 Total Lines 1 and 2 – Line 1 plus(+) Line 2 and list the totals. Line 4 Beginning Inventory Indiana Stamped – The number of stamped cartons (by size type) in inventory at the beginning of the period. This should be the same numbers as reported for the closing inventory from the previous monthly CT16-P (Line 2). Line 5 Purchased Indiana Stamped – Schedule “CPC” – The number of stamped cartons (by size type) purchased from another Indiana Licensed Distributor during the period. These figures are carried forward from the totals on Schedule CT-18P-CPC. Line 6 Total Lines 4 and 5 – Line 4 plus(+) Line 5 and list the totals. Line 7 Quantity Stamped: Line 3 Minus Line 6 – Line 3 minus(-) Line 6 and enter the totals. Line 8 Tax Rate Per Item Stamped – This is the listing of tax rates for each carton type. Line 9 Tax Due Per Items Stamped – Line 7 multiplied(x) by Line 8 and enter the dollar amounts. Line 10 Total Tax Due: Add Line 9 All Columns – Add the totals from the columns on Line 9 and list the grand total due. Part II – Stamp Accountability Line 11 Beginning Inventory of Tax Stamps – The dollar value of the stamps (unattached to cartons or the return) in inventory at the beginning of the period. This should be the same figure as reported for the closing inventory from the previous monthly CT16-P (Line 14). Line 12 Add Purchases During Month – List the invoice date and invoice number of each stamp purchase made during period. Place the total purchase dollar amount in the far right column. Line 13 Total Lines 11 and 12 – Line 11 plus(+) Line 12 and enter the dollar amount. (CT16-P Instructions cont.) Line 14 Deduct Closing Inventory of Tax Stamps – List the number of stamps (unattached to cartons or the return) in inventory at the end of the period. List the dollar amount of stamps in the closing inventory in the far right column. Line 15 Stamps Used During Month – Line 13 minus(-) Line 14(dollar amount) and enter the total. Line 16 Overage/Shortage Line 10 Minus Line 15 – Line 10 minus(-) Line 15 equals the amount of tax over or under stamped. American LegalNet, Inc. www.FormsWorkflow.com