Form E681 "Excise Act, 2001 - Refund Claim of Tax on Exported Tobacco Products" - Canada

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when completed
Excise Act, 2001
Refund Claim of Tax on Exported Tobacco Products
Business name
Send this completed application to:
Canada Revenue Agency
Prince Edward Island Tax Centre
275 Pope Road
Mailing address
Summerside PE C1N 6E7
City
Province/State
Country
Postal or ZIP code
Please read the instructions on page 2 and 4 before completing this return.
Account number
Date of export (YYYYMMDD)
TTB number / Tobacco products commercial
1
3
4
permit number
R
D
Language of communication
2
Expiry date (where applicable) (YYYYMMDD)
English
French
5. Refund amounts
Commodity
Refund code
Amount claimed
Total refund claimed – Cigarettes
4958001
Total refund claimed – Tobacco sticks
4958101
Total refund claimed – Manufactured tobacco
4958201
6. Total amount claimed
7. Currency:
US$
Other (specify):
8. Refund options
Select one of the following options:
I want to receive the refund by cheque or direct deposit (see instructions on page 2).
Transfer $
to the following account number and reporting period end:
Reporting period ending
YYYY
MM
DD
Enter account number
(15 digits)
Certification
I,
,
Print name
Position or office
certify that the amount claimed or any part of it has not been claimed before and the information on this application is, to the best of my knowledge, correct and
complete.
Telephone number
Ext.
Signature
Date (YYYYMMDD)
Note: You can authorize a business representative through My Business Account or by sending us a completed Form RC59, Business Consent. Go to
canada.ca/en/revenue-agency/services/tax/businesses/topics/registering-your-business/authorize-a-representative-business-number
for more information.
(Ce formulaire est disponible en français.)
E681 E (19)
Page 1 of 4
Clear Data
Protected B
when completed
Excise Act, 2001
Refund Claim of Tax on Exported Tobacco Products
Business name
Send this completed application to:
Canada Revenue Agency
Prince Edward Island Tax Centre
275 Pope Road
Mailing address
Summerside PE C1N 6E7
City
Province/State
Country
Postal or ZIP code
Please read the instructions on page 2 and 4 before completing this return.
Account number
Date of export (YYYYMMDD)
TTB number / Tobacco products commercial
1
3
4
permit number
R
D
Language of communication
2
Expiry date (where applicable) (YYYYMMDD)
English
French
5. Refund amounts
Commodity
Refund code
Amount claimed
Total refund claimed – Cigarettes
4958001
Total refund claimed – Tobacco sticks
4958101
Total refund claimed – Manufactured tobacco
4958201
6. Total amount claimed
7. Currency:
US$
Other (specify):
8. Refund options
Select one of the following options:
I want to receive the refund by cheque or direct deposit (see instructions on page 2).
Transfer $
to the following account number and reporting period end:
Reporting period ending
YYYY
MM
DD
Enter account number
(15 digits)
Certification
I,
,
Print name
Position or office
certify that the amount claimed or any part of it has not been claimed before and the information on this application is, to the best of my knowledge, correct and
complete.
Telephone number
Ext.
Signature
Date (YYYYMMDD)
Note: You can authorize a business representative through My Business Account or by sending us a completed Form RC59, Business Consent. Go to
canada.ca/en/revenue-agency/services/tax/businesses/topics/registering-your-business/authorize-a-representative-business-number
for more information.
(Ce formulaire est disponible en français.)
E681 E (19)
Page 1 of 4
Clear Data
Instructions for completing page 1
Use this form to claim a refund on exported tobacco products under the Excise Act, 2001. The following documents must be attached to your
completed refund claim:
a copy of all customs forms related to your refund claim;
a copy of Form E60, Tobacco Products Export Form, supplied by the exporter; and
if this is the first time you are filing this form, you have to provide the Canada Revenue Agency with a copy of your TTB certificate or
tobacco products commercial permit related to the tobacco products. Also, if the information on the certificate has changed,
a new copy of your certificate/permit will be required.
Identification
Enter the legal name and mailing address of the business. For sole proprietorships and partnerships,
enter the first and last names. For corporations, enter the legal name.
1. Account number
Enter the account number that was assigned to you for refund purposes.
2. Language of communication
Check the appropriate box.
3. Date of export
Enter the date of export using the year, month, day format (YYYYMMDD).
Enter your Alcohol and Tobacco Tax and Trade Bureau (TTB) number in this area (for U.S. residents only) or
4. TTB number / Tobacco products
your tobacco products commercial permit number (for all other countries).
commercial permit number
This number is mandatory. Not providing this information could result in delay or denial of your claim.
Expiry date
Enter the expiry date where applicable using the year, month, day format (YYYYMMDD).
5. Refund amounts
Enter the amount claimed in the appropriate commodity row(s).
6. Total amount claimed
Add section 5 amount(s), and enter the total claim amount in section 6.
7. Currency
Check the appropriate box to indicate the currency used in sections 5 and 6. If you check "Other," specify currency.
Select the option that describes how you want your refund issued or applied. To start direct deposit or to change
8. Refund options
your deposit information, complete and send us Form
RC366, Direct Deposit Request for
Businesses.
Certification
An authorized person must sign this refund claim certifying that the information provided on it is, to the best of my
knowledge, correct and complete. We will only process the application if this section has been completed.
Note:
Subsection 182(1) of the Excise Act, 2001 specifies that a refund will not be paid unless you file this application within two (2) years of the product being exported
to the foreign country.
Only one Form E60 for each Form E681 will be accepted.
If you have any questions about filing this refund claim, you can call us toll free from anywhere in Canada or the United States at 1-877-432-5472 (bilingual
service) or from other countries at 613-221-3073 (we accept collect calls).
Page 2 of 4
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9. Details of importation
Manufacturer's export no.
Bill of lading number / Air, sea and waybill number
Name of exporter
Mailing address
City
Province / State
Country
Postal code / Zip code
10. Details of application
YYYY
MM
DD
Customs entry no.
Customs
Transaction no. 1
entry date
Tobacco
Manufactured
Cigarettes
sticks
tobacco
Text
Text
Total number of cigarettes
Text
Text
Total number of tobacco sticks
Text
Text
Total weight of manufactured tobacco
lb.
kg
(1)
(2)
(3)
Excise tax/duty paid outside Canada
YYYY
MM
DD
Customs entry no.
Customs
Transaction no. 2
entry date
Tobacco
Manufactured
Cigarettes
sticks
tobacco
Text
Text
Total number of cigarettes
Text
Text
Total number of tobacco sticks
Text
Text
lb.
kg
Total weight of manufactured tobacco
(1)
(2)
(3)
Excise tax/duty paid outside Canada
YYYY
MM
DD
Customs entry no.
Customs
Transaction no. 3
entry date
Tobacco
Manufactured
Cigarettes
sticks
tobacco
Text
Text
Total number of cigarettes
Text
Text
Total number of tobacco sticks
Text
Text
Total weight of manufactured tobacco
lb.
kg
(1)
(2)
(3)
Excise tax/duty paid outside Canada
YYYY
MM
DD
Customs entry no.
Customs
Transaction no. 4
entry date
Tobacco
Manufactured
Cigarettes
sticks
tobacco
Text
Text
Total number of cigarettes
Text
Text
Total number of tobacco sticks
Text
Text
Total weight of manufactured tobacco
lb.
kg
(1)
(2)
(3)
Excise tax/duty paid outside Canada
If you have more than four transactions to report, use more pages or provide an attachment in the same format.
Personal information is collected for purposes of the administration or enforcement of the Excise Tax Act, 2001 and related programs and activities such as administering tax, rebates, elections,
audit, compliance, and collection. Personal information may be shared for the purposes of other federal Acts that provide for the imposition and collection of a tax or duty. Personal information may
also be shared with other federal, provincial, territorial or foreign government institutions to the extent authorized by law. Failure to provide this information may result in interest payable, penalties
or other actions. Under the Privacy Act, individuals have the right to access their personal information, request correction, or file a complaint to the Privacy Commissioner of Canada regarding the
handling of the individual’s personal information. Refer to Personal Information Bank CRA PPU 224 at canada.ca/cra-info-source.
Page 3 of 4
Clear Data
Instructions for completing page 3
9. Details of importation
Manufacturer's export number – Enter the Manufacturer's export number from Form E60.
Bill of lading number / Air, sea / land waybill number – Enter the applicable number.
Name and address of exporter – Enter the legal name and the mailing address of the exporter.
10. Details of application
You must complete a Transaction area for each transaction from your customs form for which you are
claiming a refund.
Customs entry no. – Enter the entry number from the customs form.
Customs entry date – Enter the entry date from the customs form.
Total number of cigarettes – Enter the total number of units for cigarettes.
Total number of tobacco sticks – Enter the total number of units for tobacco sticks.
Total weight of manufactured tobacco – Enter the total weight of manufactured tobacco. Check the
appropriate box (pound (lb.) or kilogram (kg)) to indicate the unit of measure used.
Excise tax/duty paid outside Canada – Enter the amount of federal excise tax/duty paid for
(1) Cigarettes, (2) Tobacco sticks, and (3) Manufactured tobacco.
For each commodity, enter the total of the amounts entered here for all transactions reported on this
application in the "Amount claimed" column in section 5 on page 1.
Page 4 of 4