Form CIG 50004 2011 Consolidated Monthly Cigarette Return Including Multi-State and Tribal Rates - Oklahoma

Form CIG50004 is a Oklahoma Tax Commission form also known as the "Consolidated Monthly Cigarette Return Including Multi-state And Tribal Rates". The latest edition of the form was released in October 1, 2011 and is available for digital filing.

Download a fillable PDF version of the Form CIG50004 down below or find it on Oklahoma Tax Commission Forms website.

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Consolidated Monthly Cigarette Return Including Multi-State and Tribal Rates
CIG 50004
Oklahoma Tax Commission
Revised 10-2011
Indicate
2501 North Lincoln Boulevard
Denomination:
Oklahoma City, OK 73194
Taxpayer FEIN
Period of Return
Cigarette License Number
20’s
25’s
____________________________________________________________________ _
_ _ ___________________________________________________________
Firm Name
Contact Person
____________________________________________________________________ _
_ _ ___________________________________________________________
Address
Contact Telephone Number
____________________________________________________________________
City
State
Zip
Indicate Tax
Indicate Tax
Indicate Tax
Indicate Tax
Indicate Tax
Indicate Tax
Indicate Tax
Total
Full Tax Rate
Cigarette Tax Stamps
Jurisdiction
Jurisdiction
Jurisdiction
Jurisdiction
Jurisdiction
Jurisdiction
Jurisdiction
1. On Hand-Beginning of Period
2. Add: Stamps Purchased
3. Total (add lines 1 and 2)
4. Deduct: Stamps Affixed to Packs
5. Deduct: Other Legal Deductions
(attach documentation)
6. Total Deductions (add lines 4 and 5)
7. On Hand-Close of Period
Stamped Cigarettes
8. On Hand-Beginning of Period
9. Add: Packages Stamped
(from line 4)
10._Add: Packages Purchased with
_ _Stamps Affixed
11. Add: Adjustment - Shortage
12. Deduct: Adjustment - Unaccountable
13. Deduct: Sales (attach sales report)
14. On Hand-Close of Period
Unstamped Cigarettes
15. On Hand-Beginning of Period
16. Add: Unstamped Cigarettes Purchased
17. Add: Adjustment - Unaccountable
The return must be filled out completely and in detail and submitted within 10 days
18. Total (add lines 15, 16 and 17)
following the end of the preceding returning period.
19. Deduct: Packages Stamped
(from line 4)
20. Deduct: Other Legal Deductions
(attach documentation)
21. Deduct: Adjustment - Shortage
22. Total Deductions (add lines 19, 20, and 21)
23. On Hand-Close of Period
I, the undersigned wholesaler, distributor, jobber or duly authorized legal representative thereof do declare under the penalties of perjury that this report, including the accompanying schedules which are made a part thereof, is to the best
of my knowledge and belief true and correct.
Signature:_ ________________________________________________________
Official Title: ___________________________________________________
Date: _ _ ______________________
Consolidated Monthly Cigarette Return Including Multi-State and Tribal Rates
CIG 50004
Oklahoma Tax Commission
Revised 10-2011
Indicate
2501 North Lincoln Boulevard
Denomination:
Oklahoma City, OK 73194
Taxpayer FEIN
Period of Return
Cigarette License Number
20’s
25’s
____________________________________________________________________ _
_ _ ___________________________________________________________
Firm Name
Contact Person
____________________________________________________________________ _
_ _ ___________________________________________________________
Address
Contact Telephone Number
____________________________________________________________________
City
State
Zip
Indicate Tax
Indicate Tax
Indicate Tax
Indicate Tax
Indicate Tax
Indicate Tax
Indicate Tax
Total
Full Tax Rate
Cigarette Tax Stamps
Jurisdiction
Jurisdiction
Jurisdiction
Jurisdiction
Jurisdiction
Jurisdiction
Jurisdiction
1. On Hand-Beginning of Period
2. Add: Stamps Purchased
3. Total (add lines 1 and 2)
4. Deduct: Stamps Affixed to Packs
5. Deduct: Other Legal Deductions
(attach documentation)
6. Total Deductions (add lines 4 and 5)
7. On Hand-Close of Period
Stamped Cigarettes
8. On Hand-Beginning of Period
9. Add: Packages Stamped
(from line 4)
10._Add: Packages Purchased with
_ _Stamps Affixed
11. Add: Adjustment - Shortage
12. Deduct: Adjustment - Unaccountable
13. Deduct: Sales (attach sales report)
14. On Hand-Close of Period
Unstamped Cigarettes
15. On Hand-Beginning of Period
16. Add: Unstamped Cigarettes Purchased
17. Add: Adjustment - Unaccountable
The return must be filled out completely and in detail and submitted within 10 days
18. Total (add lines 15, 16 and 17)
following the end of the preceding returning period.
19. Deduct: Packages Stamped
(from line 4)
20. Deduct: Other Legal Deductions
(attach documentation)
21. Deduct: Adjustment - Shortage
22. Total Deductions (add lines 19, 20, and 21)
23. On Hand-Close of Period
I, the undersigned wholesaler, distributor, jobber or duly authorized legal representative thereof do declare under the penalties of perjury that this report, including the accompanying schedules which are made a part thereof, is to the best
of my knowledge and belief true and correct.
Signature:_ ________________________________________________________
Official Title: ___________________________________________________
Date: _ _ ______________________
Form CIG 50004 - Page 2
Instructions for Consolidated Monthly Cigarette Return
Including Multi-State and Tribal Rates
1. Complete all requested information regarding your wholesale company.
2. Indicate whether this return is for 20 or 25 packs cigarettes. Use a separate sheet for each size cigarette packages.
3. Indicate in the column headers the tax jurisdiction you are reporting for that column, whether it is a tribal designation or another state. Use an additional page if
there are not enough columns.
4. Fill in all applicable information for each column.
5. Please note that:
Lines 1 + 2 = lines 4 + 5 + 7
_
lines 8 + 9 + 10 + 11 - 12 = lines 13 + 14
Lines 15 + 16 + 17 = lines 19 + 20 + 21 + 23
Definitions
“Full Tax Rate” – means all full-tax-rate locations in the State of Oklahoma and retail locations located on trust land owned or licensed by Federally Recognized
Indian Tribes or Nations, which have NOT signed a compact with the State of Oklahoma regarding cigarette and tobacco products.
“State/Tribal Border Compact” – means retail locations located on trust land owned or licensed by Federally Recognized Indian Tribes or Nations, which signed
compacts with the State of Oklahoma regarding cigarette and tobacco products after July1, 2008 and are located within twenty (20) miles of the state line between
Oklahoma and Kansas or Oklahoma and Missouri.
“New Compact” – means retail locations located on trust land owned or licensed by Federally Recognized Indian Tribes or Nations, which signed compacts with
the State of Oklahoma regarding cigarette and tobacco products after January 1, 2003.
“Exception Rate” – means certain retail locations on trust lands in other specific locations, owned or licensed by Federally Recognized Indian Tribes or Nations
which signed compacts with the State of Oklahoma regarding cigarettes and tobacco products after January 1, 2003 and are located within twenty (20) miles of the
state line between Oklahoma and Kansas or Oklahoma and Missouri.
“State/Tribal Compact” – means retail locations located on trust land owned or licensed by Federally Recognized Indian Tribes or Nations, which signed compacts
with the State of Oklahoma regarding cigarette and tobacco products after July1, 2008.
Black Stamp or No Tax Rate –
retail locations located on trust land owned or licensed by Federally Recognized Indian Tribes or Nations, which have NOT signed a
compact with the State of Oklahoma regarding cigarette and tobacco products. This tobacco product can only be sold to that tribe’s tribal member.

Download Form CIG 50004 2011 Consolidated Monthly Cigarette Return Including Multi-State and Tribal Rates - Oklahoma

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