Form CIG51 "Claim for Reimbursement of Cigarette Tax Illegally or Erroneously Paid and/or Unused Cigarette Tax Stamps" - Ohio

What Is Form CIG51?

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

Form Details:

  • Released on September 1, 2015;
  • The latest edition provided by the Ohio Department of Taxation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CIG51 by clicking the link below or browse more documents and templates provided by the Ohio Department of Taxation.

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Download Form CIG51 "Claim for Reimbursement of Cigarette Tax Illegally or Erroneously Paid and/or Unused Cigarette Tax Stamps" - Ohio

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CIG 51
Rev. 9/15
Reset Form
Dealer’s Account Number
P.O. Box 530
Columbus, OH 43216-0530
94-
Claim for Reimbursement of Cigarette Tax
Dealer’s Claim Number
(Dealer to Complete for Tracking)
Illegally or Erroneously Paid and/or
Unused Cigarette Tax Stamps
State File Number
For the period from
, 20
to
, 20
, inclusive.
1. Name
Print name of dealer as shown on dealer’s license
2. Address
Street
City
State
ZIP code
3.
If records are located at an address other than line 2, show on line 3.
4. Federal employer identification number or, if none assigned for
Social Security number
Federal identifi cation number
reporting federal taxes, please enter your Social Security number.
5. By an illegal or erroneous payment or assessment ......................................................................................... $
If claim is based on cigarettes returned to the manufacturer prior to July 1, 2015, state total number of such cigarettes with tax
stamps affixed and total tax amount:
6. State only stamped............ .....
x
.0625
=
$
7. Less dealers discount (line 6 x .018).......................................................... =
8. Net amount (line 6 minus line 7) ...................................................................................................................... $
9. Combined stamped.................
x
.07975
=
$
10. Less dealers discount (line 9 x .018) ......................................................... =
11. Net amount (line 9 minus line 10) .................................................................................................................... $
12. County only stamped ..............
x
.01725
=
$
13. Less dealers discount (line 12 x .018) ....................................................... =
14. Net amount (line 12 minus line 13) .................................................................................................................. $
If claim is based on cigarettes returned to the manufacturer after June 30, 2015, state total number of such cigarettes with tax stamps
affixed and total tax amount:
15. State only stamped............ .....
x
.08
=
$
16. Less dealers discount (line 15 x .018) ........................................................ =
17. Net amount (line 15 minus line 16) .................................................................................................................. $
18. Combined stamped.................
x
.09725
=
$
19. Less dealers discount (line 18 x .018) ....................................................... =
20. Net amount (line 18 minus line 19) .................................................................................................................. $
21. County only stamped ..............
x
.01725
=
$
22. Less dealers discount (line 21 x .018) ....................................................... =
23. Net amount (line 21 minus line 22) .................................................................................................................. $
CIG 51
Rev. 9/15
Reset Form
Dealer’s Account Number
P.O. Box 530
Columbus, OH 43216-0530
94-
Claim for Reimbursement of Cigarette Tax
Dealer’s Claim Number
(Dealer to Complete for Tracking)
Illegally or Erroneously Paid and/or
Unused Cigarette Tax Stamps
State File Number
For the period from
, 20
to
, 20
, inclusive.
1. Name
Print name of dealer as shown on dealer’s license
2. Address
Street
City
State
ZIP code
3.
If records are located at an address other than line 2, show on line 3.
4. Federal employer identification number or, if none assigned for
Social Security number
Federal identifi cation number
reporting federal taxes, please enter your Social Security number.
5. By an illegal or erroneous payment or assessment ......................................................................................... $
If claim is based on cigarettes returned to the manufacturer prior to July 1, 2015, state total number of such cigarettes with tax
stamps affixed and total tax amount:
6. State only stamped............ .....
x
.0625
=
$
7. Less dealers discount (line 6 x .018).......................................................... =
8. Net amount (line 6 minus line 7) ...................................................................................................................... $
9. Combined stamped.................
x
.07975
=
$
10. Less dealers discount (line 9 x .018) ......................................................... =
11. Net amount (line 9 minus line 10) .................................................................................................................... $
12. County only stamped ..............
x
.01725
=
$
13. Less dealers discount (line 12 x .018) ....................................................... =
14. Net amount (line 12 minus line 13) .................................................................................................................. $
If claim is based on cigarettes returned to the manufacturer after June 30, 2015, state total number of such cigarettes with tax stamps
affixed and total tax amount:
15. State only stamped............ .....
x
.08
=
$
16. Less dealers discount (line 15 x .018) ........................................................ =
17. Net amount (line 15 minus line 16) .................................................................................................................. $
18. Combined stamped.................
x
.09725
=
$
19. Less dealers discount (line 18 x .018) ....................................................... =
20. Net amount (line 18 minus line 19) .................................................................................................................. $
21. County only stamped ..............
x
.01725
=
$
22. Less dealers discount (line 21 x .018) ....................................................... =
23. Net amount (line 21 minus line 22) .................................................................................................................. $
CIG 51
Rev. 9/15
Page 2
If claim is for unused tax stamps, indicate quantity and total face value below.
Unused State Stamps
24. 20 stamps ...............................
x
1.60
=
$
25. 25 stamps ...............................
x
2.00
=
26. Total of lines 24 and 25................................................................... ...........
27. Less dealers discount (line 26 x .018) ....................................................... =
28. Net amount (line 26 minus line 27) .................................................................................................................. $
Unused Combined Stamps
29. 20 stamps ...............................
x
1.945
=
$
30. 25 stamps ...............................
x
2.43125
=
31. Total of lines 29 and 30................................................................... ...........
32. Less dealers discount (line 31 x .018) ....................................................... =
33. Net amount (line 31 minus line 32) ................................................................................................................. $
Unused County Only Stamps
34. 20 stamps ...............................
x
.345
=
$
35. 25 stamps ...............................
x
.43125
=
36. Total of lines 34 and 35................................................................... ...........
37. Less dealers discount (line 36 x .018) ....................................................... =
38. Net amount (line 36 minus line 37) ................................................................................................................. $
39. Total amount of claim (add lines 8, 11, 14, 17, 20, 23, 28, 33 and 38)....................................................... $
See instructions below.
I have examined this claim and any adjustments in computation have been explained
For Departmental Use Only
to me by the agent.
Voucher No.
Signed
GRF
Telephone number
Date
County Tax
Instructions
turer’s returned goods authorization, a copy of the bill of lading
The absence of complete records in the support of this claim will
showing the return of such cigarettes to the manufacturer, an
constitute a justifiable ground for disallowance of the claim by the
affidavit from the cigarette manufacturer acknowledging receipt
department.
of cigarettes to which such stamps have been affixed, and a
This claim for reimbursement must be filed in accordance with the
copy of the credit memorandum issued by the manufacturer.
provisions relative thereto as set forth in Ohio Revised Code section
Each dealer must assign a claim number to each claim submitted
5743.05. An application shall be filed with the tax commissioner, on
the form prescribed by him for such purpose, after it is ascertained
and shown in space provided for dealer tracking purposes. This
number must be in numerical sequence, starting with No. 1. In
that the payment was erroneous, or from the date that cigarettes on
this way, all dealers submitting claims will have a claim number
which taxes have been paid have been sold in interstate or foreign
sequence.
commerce or have become unsalable; provided that in any event
the application for refund of taxes erroneously paid must be filed
Original copy to be filed with the Department of Taxation, Excise Tax
with the commissioner within three years from the date of such
Unit, P.O. Box 530, Columbus, OH 43216-0530. Duplicate copy
erroneous payment.
to be retained by applicant. If you have any questions, please call
the Excise Tax Unit at (855) 466-3921.
A claim for reimbursement of the tax represented by used cigarette
tax stamps must be supported by a copy of the cigarette manufac-
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