Wholesalers Certification Of NPM Brands Form. This is a North Dakota form and can be use in Office Of State Tax Commissioner Statewide.
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WHOLESALERS CERTIFICATION OF NPM BRANDS OFFICE OF STATE TAX COMMISSIONER SFN 23504 This return must be ﬁled on or before the 15th day of the month following the quarter during which the cigarettes and roll-your-own were sold. Individual or Business Name, Mailing Address, City, State, Zip Code (enter name as it appears on the Cigarette and Tobacco Products License.) Cigarette and Tobacco Products License No. Contact Name Enter Brand Name Year: Employer ID or Soc. Sec. No. Enter Brand Name For the month of: Daytime Phone No. Enter Brand Name Enter Brand Name Enter Brand Name Month here: __________________ here: __________________ here: __________________ here: __________________ here: __________________ Total Cigarettes I certify, by my signature, the number of cigarettes reported above represents the cigarettes, identiﬁed as NPM products, taxed in the state of North Dakota for this time period. Name _________________________________ Date _________________________________ American LegalNet, Inc. www.FormsWorkFlow.com Instructions for Wholesalers Certiﬁcation of NPM Brands 1. All wholesalers must submit a certiﬁcation regardless of whether they have brands to report. 2. All reporting is to be done by individual sticks, not packs or cartons on taxable North Dakota sales, not purchases, in the reporting period. 3. Review brands to determine whether subject to certiﬁcation. A brand list is available at www.nd.gov/tax. Select Tobacco from the menu on the homepage then from the drop down list select Publications. Under Brand Information open Participating Manufacturers Brand List. If the brand is on the list it need not be reported for certiﬁcation. 4. Enter the months being certiﬁed and then enter the speciﬁc brand in the Brand Name column heading. All members of a brand family will be reported under one brand name. 5. For RYO product brand names convert the ounces sold and taxed in North Dakota to individual cigarettes using the regular .09 grams/cigarette factor. 6. Place the number of individual cigarettes sold and taxed in North Dakota in the reporting period under the corresponding brand name. Units sold will be those invoiced to the customer in a reporting period even though they may still be on a truck and not yet delivered. 7. Contact John Quinlan at 701-328-3475 or at firstname.lastname@example.org if there are any questions regarding the form or brand names. American LegalNet, Inc. www.FormsWorkFlow.com