Form CG-27 Schedule D-1 "Request for Refund of Stamped Unsaleable Cigarettes" - Kansas

What Is Form CG-27 Schedule D-1?

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

Form Details:

  • Released on November 1, 2018;
  • The latest edition provided by the Kansas Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form CG-27 Schedule D-1 by clicking the link below or browse more documents and templates provided by the Kansas Department of Revenue.

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Download Form CG-27 Schedule D-1 "Request for Refund of Stamped Unsaleable Cigarettes" - Kansas

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481818
KANSAS DEPARTMENT OF REVENUE
REQUEST FOR REFUND OF STAMPED UNSALEABLE CIGARETTES
SCHEDULE D-1
:
#:
Name of Distributor
Distributor License
:
Date of Destruction
SECTION I
Kansas Stamped Cigarettes
Less .80%
KDOR Count of
Distributor Count
Tax Rate
Gross Tax
Net Tax Paid
Wholesaler
Packs
of Packs
Amount
Discount
$1.29
(20s)
$1.61
(25s)
Grand total of tax paid
Less: .80% (Processing Fee)
Net refund
SECTION Il
State of
stamped cigarettes*
KDOR Count of
Distributor Count
State, County or
*
One sheet per state
20s, 25s, etc.
Packs
of Packs
City Stamp
SECTION Ill
Reason for claim:
SECTION IV
The undersigned states that these stamped unsaleable cigarettes were destroyed and that all packages of cigarettes had
the above-mentioned state’s indicia affixed.
Name of Distributor’s Designee (print)
Name and Title of Kansas Inspector (print)
Signature of Distributor’s Designee
Signature of Kansas Inspector
Phone of Distributor’s Designee
Phone of Inspector
CG-27
Rev. 11-18
481818
KANSAS DEPARTMENT OF REVENUE
REQUEST FOR REFUND OF STAMPED UNSALEABLE CIGARETTES
SCHEDULE D-1
:
#:
Name of Distributor
Distributor License
:
Date of Destruction
SECTION I
Kansas Stamped Cigarettes
Less .80%
KDOR Count of
Distributor Count
Tax Rate
Gross Tax
Net Tax Paid
Wholesaler
Packs
of Packs
Amount
Discount
$1.29
(20s)
$1.61
(25s)
Grand total of tax paid
Less: .80% (Processing Fee)
Net refund
SECTION Il
State of
stamped cigarettes*
KDOR Count of
Distributor Count
State, County or
*
One sheet per state
20s, 25s, etc.
Packs
of Packs
City Stamp
SECTION Ill
Reason for claim:
SECTION IV
The undersigned states that these stamped unsaleable cigarettes were destroyed and that all packages of cigarettes had
the above-mentioned state’s indicia affixed.
Name of Distributor’s Designee (print)
Name and Title of Kansas Inspector (print)
Signature of Distributor’s Designee
Signature of Kansas Inspector
Phone of Distributor’s Designee
Phone of Inspector
CG-27
Rev. 11-18
INSTRUCTIONS
General Information
Kansas distributors who have stamped cigarettes that need to be destroyed use this form.
Prior to calling the assigned inspector, the following must be completed:
1. Complete the Schedule D-1. Keep the schedule at your establishment and submit it to the inspector at the time of
the appointment.
2. Arrange the cigarettes so that the tax stamp is showing.
3. The cigarettes must be arranged in a way to resemble a carton (2 x 5) for easy viewing
4. The cigarettes should be arranged so that all states, counties, cities, and denominations are grouped together.
5. Your company will provide a shredder at the location.
The Kansas Department of Revenue will witness the destruction of stamped cigarettes once per quarter per
distributor. Each distributor must contact their assigned inspector prior to the 10
th
day of April, July, October, and
th
January. Inspector will witness the destruction by the 30
day of the specified months.
Instructions for Schedule D-1
1. Each distributor will count the number of Kansas stamped cigarettes and enter the amount in the column marked
Distributor Count of Packs in Section I.
2. If the distributor has stamped cigarettes from a state other than Kansas, they will write the state name above
Section II then count the number of stamped cigarettes and enter the amount in the column marked Distributor
Count of Packs. NOTE: Use only one Schedule D-1 per state.
3. The distributor will then enter the denomination of the stamps in the column marked 20s, 25s, etc.
4. Next is the state, county, or city in the box marked State, County, or City Stamp. Please enter the county or city
name in the box (if applicable).
5. Enter a reason for the claim (ex.: damaged cigarettes) in Section III.
6. Write the name and license number of the Distributor in Section IV.
7. Write the name and phone number of the distributor’s designee.
8. The designee must sign the form.
When the inspector verifies the amounts and witnesses the destruction of the cigarettes, the date of destruction will
be entered. The inspector will then sign the refund request. The inspector will take the original schedule and leave a
copy with you if the cigarettes were stamped with a Kansas stamp. The Schedule D-1 will then be submitted for
processing. However, if the cigarettes were stamped with another state’s stamp, you will retain the original and the
inspector will take a copy. It will be your responsibility to send the original form to the corresponding state.
If you have any questions or need additional assistance, please contact our office at 785-368-8222, choose option 5
followed by option 4 from 8 a.m. to 4:45 p.m., Monday through Friday, and email us at: kdor_cigtob@ks.gov, or if
needing forms visit our website at: http://www.ksrevenue.org/bustaxtypescig.html.
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