Form 70-044 Iowa Cigarette Tax Stamp Order Form - Iowa

Form 70-044 is a Iowa Department of Revenue form also known as the "Iowa Cigarette Tax Stamp Order Form". The latest edition of the form was released in October 17, 2017 and is available for digital filing.

Download an up-to-date Form 70-044 in PDF-format down below or look it up on the Iowa Department of Revenue Forms website.

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Iowa Cigarette Tax Stamp Order Form
https://tax.iowa.gov
e-Mail this form to:
Questions:
Permit Number
idreft@iowa.gov
515-281-8807
Fax this form to:
Purchaser’s Name
515-281-5830
Mail this form to:
Street Address
Iowa Department of Revenue
Cigarette Stamp Order Processing
PO Box 10472
City, State, ZIP
rd
1305 E. Walnut St – Hoover Building 3
Floor
Des Moines, IA 50306-0472
See reverse side for information on stamps.
Type
Pack
Carton
Units
Tax Value
Less 2%
Stamp Type
Gross Cost
Net Cost
Ordered
#
Size
Layout
Per Unit
Discount
1
20’s
2 x 5
Roll(s) of 30,000
@$40,800.00
2
20’s
2 x 5
Sheet(s) of 150
@$204.00
Sheet(s) of 150
3
20’s
1 x 10
@$204.00
(Camel wides)
6
25’s
1 x 10
Sheet(s) of 150
@$255.00
Payment Type (indicate preference):
Total amount due with order ________________
Check. Make check payable to: Treasurer – State of Iowa
Check Number _______________
When you pay by check, you authorize the
Check Date __________________
Department of Revenue to convert your check
Electronic Payment
to a one-time electronic banking transaction.
Confirmation Number _____________
Delivery Method (indicate preference):
In accordance with the Iowa Department of Revenue’s mailing policy.
Walk-in. _______________________________________________
FedEx Next Day 12:00 Service – at Permit Holder’s expense.
FedEx Account # ___________________________________
______________________________
_____________
______________________
___________________
Signature of Purchaser
Date
e-Mail Address
Telephone Number
FOR AUTHORIZED AGENT’S USE ONLY
The undersigned states that he/she is authorized to sell Cigarette Stamps as an agent of the Iowa Department of Revenue
and certifies that the information contained is correct and that the total revenue collected is as stated.
Iowa Department of Revenue or __________________________________________________
Agent’s Organization
____________________________________________________
___________________________________________________________
Agent’s Printed Name
Signature of Agent
Date
Stamp Type
Stamp Serial Numbers
______________________
_________________ to ________________
______________________
_________________ to ________________
______________________
_________________ to ________________
______________________
_________________ to ________________
______________________
_________________ to ________________
______________________
_________________ to ________________
70-044a (10/17/17)
Iowa Cigarette Tax Stamp Order Form
https://tax.iowa.gov
e-Mail this form to:
Questions:
Permit Number
idreft@iowa.gov
515-281-8807
Fax this form to:
Purchaser’s Name
515-281-5830
Mail this form to:
Street Address
Iowa Department of Revenue
Cigarette Stamp Order Processing
PO Box 10472
City, State, ZIP
rd
1305 E. Walnut St – Hoover Building 3
Floor
Des Moines, IA 50306-0472
See reverse side for information on stamps.
Type
Pack
Carton
Units
Tax Value
Less 2%
Stamp Type
Gross Cost
Net Cost
Ordered
#
Size
Layout
Per Unit
Discount
1
20’s
2 x 5
Roll(s) of 30,000
@$40,800.00
2
20’s
2 x 5
Sheet(s) of 150
@$204.00
Sheet(s) of 150
3
20’s
1 x 10
@$204.00
(Camel wides)
6
25’s
1 x 10
Sheet(s) of 150
@$255.00
Payment Type (indicate preference):
Total amount due with order ________________
Check. Make check payable to: Treasurer – State of Iowa
Check Number _______________
When you pay by check, you authorize the
Check Date __________________
Department of Revenue to convert your check
Electronic Payment
to a one-time electronic banking transaction.
Confirmation Number _____________
Delivery Method (indicate preference):
In accordance with the Iowa Department of Revenue’s mailing policy.
Walk-in. _______________________________________________
FedEx Next Day 12:00 Service – at Permit Holder’s expense.
FedEx Account # ___________________________________
______________________________
_____________
______________________
___________________
Signature of Purchaser
Date
e-Mail Address
Telephone Number
FOR AUTHORIZED AGENT’S USE ONLY
The undersigned states that he/she is authorized to sell Cigarette Stamps as an agent of the Iowa Department of Revenue
and certifies that the information contained is correct and that the total revenue collected is as stated.
Iowa Department of Revenue or __________________________________________________
Agent’s Organization
____________________________________________________
___________________________________________________________
Agent’s Printed Name
Signature of Agent
Date
Stamp Type
Stamp Serial Numbers
______________________
_________________ to ________________
______________________
_________________ to ________________
______________________
_________________ to ________________
______________________
_________________ to ________________
______________________
_________________ to ________________
______________________
_________________ to ________________
70-044a (10/17/17)
Iowa Cigarette Tax Payment Indicators
IOWA CIGARETTE TAX STAMP TYPES
Tax
Stamp
Cost of
Carton
Type
Configuration
Application
Types of Indicators
Value
Minimum Quantity
Used On
1
Rolls of Heat Applied
$1.36
30,000 stamps per roll
Packs of 20’s
2 x 5
Meyercord Machine,
$40,800.00 gross
or Hand Iron
$39,984.00 net
2
Sheets of Heat Applied
$1.36
150 stamps per sheet
Packs of 20’s
2 x 5
Hand Iron
$204.00 gross
$199.92 net
3
Sheets of Heat Applied
$1.36
150 stamps per sheet
Camel Wides 20’s
1 x 10
R J Reynolds
$204.00 gross
Hand Iron
$199.92 net
6
Sheets of Heat Applied
$1.70
150 stamps per sheet
Packs of 25’s.
1 x 10
Hand Iron
$255.00 gross
Richland 25’s
$249.90 net
70-044b (12/03/15)

Download Form 70-044 Iowa Cigarette Tax Stamp Order Form - Iowa

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