Form CT-1B "Sales to Agencies of the United States" - Massachusetts

What Is Form CT-1B?

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

Form Details:

  • Released on March 1, 2015;
  • The latest edition provided by the Massachusetts Department of Revenue;
  • 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 printable version of Form CT-1B by clicking the link below or browse more documents and templates provided by the Massachusetts Department of Revenue.

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Download Form CT-1B "Sales to Agencies of the United States" - Massachusetts

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Massachusetts Department of Revenue
Form CT-1B
Sales to Agencies of the United States
This is to acknowledge receipt of untaxed cigarettes, herein described, which have been purchased by an authorized post exchange or ships
service store or for use by the United States government, and to certify that the sale of such cigarettes will be made only in accordance with
the regulations governing such agency.
Name of wholesaler
Date of sale (mm/dd/yyyy)
Invoice number
Street address of wholesaler
City/Town
State
Zip
Name of agency
Street address of agency
City/Town
State
Zip
Brand of cigarettes
Quantity
Brand of cigarettes
Quantity
Brand of cigarettes
Quantity
Total. Enter on Form CT-1, line 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Declaration
The undersigned certifies under the penalties of perjury that all lines and statements herein contained or upon schedules attached hereto are
true and accurate in every particular.
Signature of authorized agent
Title
Date
This acknowledgment must be made for each sale of cigarettes to the United States or an agency thereof, and made a part of the monthly cigarette
excise report. No deduction of the excise will be allowed on Form CT-1, line 4 unless the sale is made to an authorized agency and acknowledgment
is properly signed by an authorized employee of the United States government.
Rev. 3/15
Massachusetts Department of Revenue
Form CT-1B
Sales to Agencies of the United States
This is to acknowledge receipt of untaxed cigarettes, herein described, which have been purchased by an authorized post exchange or ships
service store or for use by the United States government, and to certify that the sale of such cigarettes will be made only in accordance with
the regulations governing such agency.
Name of wholesaler
Date of sale (mm/dd/yyyy)
Invoice number
Street address of wholesaler
City/Town
State
Zip
Name of agency
Street address of agency
City/Town
State
Zip
Brand of cigarettes
Quantity
Brand of cigarettes
Quantity
Brand of cigarettes
Quantity
Total. Enter on Form CT-1, line 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Declaration
The undersigned certifies under the penalties of perjury that all lines and statements herein contained or upon schedules attached hereto are
true and accurate in every particular.
Signature of authorized agent
Title
Date
This acknowledgment must be made for each sale of cigarettes to the United States or an agency thereof, and made a part of the monthly cigarette
excise report. No deduction of the excise will be allowed on Form CT-1, line 4 unless the sale is made to an authorized agency and acknowledgment
is properly signed by an authorized employee of the United States government.
Rev. 3/15