Form T-11 "Requisition for Cigarette Tax Stamps" - Rhode Island

What Is Form T-11?

This is a legal form that was released by the Rhode Island Department of Revenue - a government authority operating within Rhode Island. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2017;
  • The latest edition provided by the Rhode Island Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of Form T-11 by clicking the link below or browse more documents and templates provided by the Rhode Island Department of Revenue.

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Download Form T-11 "Requisition for Cigarette Tax Stamps" - Rhode Island

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State of Rhode Island and Providence Plantations
Form T-11
Requisition for Cigarette Tax Stamps
Name
Federal employer identification number
Check one:
Address
Requisition date
Cash order -
Key #12
Address 2
License number
Charge order -
Key #58
City, town or post office
State
ZIP code
Email address
PREPARE THIS ORDER IN DUPLICATE, KEEPING A COPY FOR YOUR FILES.
SUBMIT THE ORIGINAL TO THE DIVISION OF TAXATION AT TIME OF PURCHASE.
(DO NOT COMBINE ORDERS FOR 20’S AND 25’S ON SAME FORM)
UNLESS YOU HAVE ARRANGED CREDIT, ENCLOSE A REMITTANCE FOR
THE TOTAL AMOUNT OF THIS ORDER PAYABLE TO RI DIVISION OF TAXATION.
Use Form T-11A to requisition cigarette tax stamps for rolling papers.
Please furnish the Cigarette Tax Stamps listed below:
TAX DIVISION USE ONLY
All purchases must be made at the RI Division of Taxation, Cashier’s Office
DENOMINATIONS
QUANTITY
VALUE
BEGINNING NUMBER
ENDING NUMBER
Loose 20’s @ $ 4.25 per stamp
1
Loose 25’s @ $ 5.31 per stamp
2
127,500.00
$
per roll
3
Total face value of stamps. Add lines 1, 2 and 3
4
1.25% discount. Multiply line 4 by 0.0125...........
5
- - - LICENSED DISTRIBUTORS ONLY - - -
Net stamp order. Subtract line 5 from line 4........
6
Prepaid sales tax @ $ 17,400.00 per roll x # of rolls
7
Prepaid sales tax @ $ 0.58 per stamp x # of stamps
8
9
TOTAL VALUE OF ORDER...........................................
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and
belief, it is true, accurate and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Authorized officer signature
Print name
Date
Telephone number
Paid preparer signature
Print name
Date
Telephone number
Paid preparer address
City, town or post office
State
ZIP Code
PTIN
May the Division of Taxation contact your preparer? YES
Revised 08/2017
State of Rhode Island and Providence Plantations
Form T-11
Requisition for Cigarette Tax Stamps
Name
Federal employer identification number
Check one:
Address
Requisition date
Cash order -
Key #12
Address 2
License number
Charge order -
Key #58
City, town or post office
State
ZIP code
Email address
PREPARE THIS ORDER IN DUPLICATE, KEEPING A COPY FOR YOUR FILES.
SUBMIT THE ORIGINAL TO THE DIVISION OF TAXATION AT TIME OF PURCHASE.
(DO NOT COMBINE ORDERS FOR 20’S AND 25’S ON SAME FORM)
UNLESS YOU HAVE ARRANGED CREDIT, ENCLOSE A REMITTANCE FOR
THE TOTAL AMOUNT OF THIS ORDER PAYABLE TO RI DIVISION OF TAXATION.
Use Form T-11A to requisition cigarette tax stamps for rolling papers.
Please furnish the Cigarette Tax Stamps listed below:
TAX DIVISION USE ONLY
All purchases must be made at the RI Division of Taxation, Cashier’s Office
DENOMINATIONS
QUANTITY
VALUE
BEGINNING NUMBER
ENDING NUMBER
Loose 20’s @ $ 4.25 per stamp
1
Loose 25’s @ $ 5.31 per stamp
2
127,500.00
$
per roll
3
Total face value of stamps. Add lines 1, 2 and 3
4
1.25% discount. Multiply line 4 by 0.0125...........
5
- - - LICENSED DISTRIBUTORS ONLY - - -
Net stamp order. Subtract line 5 from line 4........
6
Prepaid sales tax @ $ 17,400.00 per roll x # of rolls
7
Prepaid sales tax @ $ 0.58 per stamp x # of stamps
8
9
TOTAL VALUE OF ORDER...........................................
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and
belief, it is true, accurate and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Authorized officer signature
Print name
Date
Telephone number
Paid preparer signature
Print name
Date
Telephone number
Paid preparer address
City, town or post office
State
ZIP Code
PTIN
May the Division of Taxation contact your preparer? YES
Revised 08/2017