Form TP-17 Other Deductions for Moist Snuff - Illinois

Form TP-17 is a Illinois Department of Revenue form also known as the "Other Deductions For Moist Snuff". The latest edition of the form was released in December 1, 2012 and is available for digital filing.

Download an up-to-date Form TP-17 in PDF-format down below or look it up on the Illinois Department of Revenue Forms website.

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Illinois Department of Revenue
TP-17
Other Deductions for Moist Snuff
Read this information first
Do not write above this line.
Attach this schedule to Form TP-1, Tobacco Products Tax Return, when you claim a deduction on Form TP-1, Line 24, for a reason other than
moist snuff sold and shipped in interstate commerce, sales to other distributors, or returned merchandise. Complete this form with a brief
description of the deduction (i.e. weight-based tobacco products sold to a U.S. government agency). Samples are not allowable deductions.
If you need to identify more than 14 invoices, additional Forms TP-17 must be completed. We will accept a computer-generated schedule
as long as we approve its format and content prior to use. To obtain approval, please send a copy of your format to: Office of Publications
Management, Illinois Department of Revenue, 101 West Jefferson Street, MC 3-375, Springfield, Illinois 62702.
Step 1: Identify your business
1
3
Business name
_____________________________________
Account ID: ____ ____ ____ ____ ____ ____ ____ ____
2
4
TP
Address: _____________________________________________
License no.
– ____ ____ ____ ____ ____
Number and street
5
____________________________________________________
For what month are you filing this schedule?
_______/_______
City
State
ZIP
Month
Year
Step 2: Complete the following to support your other deductions
Reason for deduction
Reference or
Date
Number of ounces
invoice number
6 15 18
1 _______________________________________________
_______________ ___/___/___
____________________
Month Day
Year
_____________________________________________________
_____________________________________________________
2 _______________________________________________
_______________ ___/___/___
____________________
Month Day
Year
_____________________________________________________
_____________________________________________________
3 _______________________________________________
_______________ ___/___/___
____________________
Month Day
Year
_____________________________________________________
_____________________________________________________
4 _______________________________________________
_______________ ___/___/___
____________________
Month Day
Year
_____________________________________________________
_____________________________________________________
5 _______________________________________________
_______________ ___/___/___
____________________
Month Day
Year
_____________________________________________________
Complete back page if more
lines are needed in Step 2.
_____________________________________________________
Step 3: Figure your total
Add the ounces of moist snuff from all Forms TP-17 you are filing for the month listed in Step 1.
Transfer this grand total amount to Form TP-1, Step 3, Line 24.
____________________
*294F01110*
TP-17 (N-12/12)
This form is authorized as outlined by the Tobacco Products Tax Act of 1995. Disclosure
of this information is REQUIRED. Failure to provide information could result in penalties.
Use your mouse or Tab key to move through the fields. Use your mouse or space bar to enable check boxes.
Illinois Department of Revenue
TP-17
Other Deductions for Moist Snuff
Read this information first
Do not write above this line.
Attach this schedule to Form TP-1, Tobacco Products Tax Return, when you claim a deduction on Form TP-1, Line 24, for a reason other than
moist snuff sold and shipped in interstate commerce, sales to other distributors, or returned merchandise. Complete this form with a brief
description of the deduction (i.e. weight-based tobacco products sold to a U.S. government agency). Samples are not allowable deductions.
If you need to identify more than 14 invoices, additional Forms TP-17 must be completed. We will accept a computer-generated schedule
as long as we approve its format and content prior to use. To obtain approval, please send a copy of your format to: Office of Publications
Management, Illinois Department of Revenue, 101 West Jefferson Street, MC 3-375, Springfield, Illinois 62702.
Step 1: Identify your business
1
3
Business name
_____________________________________
Account ID: ____ ____ ____ ____ ____ ____ ____ ____
2
4
TP
Address: _____________________________________________
License no.
– ____ ____ ____ ____ ____
Number and street
5
____________________________________________________
For what month are you filing this schedule?
_______/_______
City
State
ZIP
Month
Year
Step 2: Complete the following to support your other deductions
Reason for deduction
Reference or
Date
Number of ounces
invoice number
6 15 18
1 _______________________________________________
_______________ ___/___/___
____________________
Month Day
Year
_____________________________________________________
_____________________________________________________
2 _______________________________________________
_______________ ___/___/___
____________________
Month Day
Year
_____________________________________________________
_____________________________________________________
3 _______________________________________________
_______________ ___/___/___
____________________
Month Day
Year
_____________________________________________________
_____________________________________________________
4 _______________________________________________
_______________ ___/___/___
____________________
Month Day
Year
_____________________________________________________
_____________________________________________________
5 _______________________________________________
_______________ ___/___/___
____________________
Month Day
Year
_____________________________________________________
Complete back page if more
lines are needed in Step 2.
_____________________________________________________
Step 3: Figure your total
Add the ounces of moist snuff from all Forms TP-17 you are filing for the month listed in Step 1.
Transfer this grand total amount to Form TP-1, Step 3, Line 24.
____________________
*294F01110*
TP-17 (N-12/12)
This form is authorized as outlined by the Tobacco Products Tax Act of 1995. Disclosure
of this information is REQUIRED. Failure to provide information could result in penalties.
Step 2: Complete the following to support your other deductions
(Cont.)
Reason for deduction
Reference or
Date
Number of ounces
invoice number
6
_______________________________________________
_______________
___/___/___
____________________
Month Day
Year
_____________________________________________________
_____________________________________________________
7
_______________________________________________
_______________
___/___/___
____________________
Month Day
Year
_____________________________________________________
_____________________________________________________
8
_______________________________________________
_______________
___/___/___
____________________
Month Day
Year
_____________________________________________________
_____________________________________________________
9 _______________________________________________
_______________
___/___/___
____________________
Month Day
Year
_____________________________________________________
_____________________________________________________
10 _______________________________________________
_______________
___/___/___
____________________
Month Day
Year
_____________________________________________________
_____________________________________________________
11 _______________________________________________
_______________
___/___/___
____________________
Month Day
Year
_____________________________________________________
_____________________________________________________
12 _______________________________________________
_______________
___/___/___
____________________
Month Day
Year
_____________________________________________________
_____________________________________________________
13 _______________________________________________
_______________
___/___/___
____________________
Month Day
Year
_____________________________________________________
_____________________________________________________
14 _______________________________________________
_______________
___/___/___
____________________
Month Day
Year
_____________________________________________________
_____________________________________________________
*294F02110*
TP-17 (N-12/12)
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