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gov revenue formsandresources forms CT206

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  • 1. MONTANA CT-206 Rev 1-05 Cigarette Tax Exempt Sale Certificate Business Name License No. Date Seller or Agent Name Phone Address Fax City State Zip Instruction for form preparation 1. Prepare in duplicate. Submit the original to Montana Department of Revenue, Customer Intake Process, P.O. Box 1712, Helena, MT 59604-1712. Retain a duplicate in company file for field audit purposes. 2. This form must be completed in its entirety. 3. The original form must accompany the form CT-205 – Cigarette Tax Report. 4. A copy of this form must accompany the form CT-207 – Wholesaler Refund Application. 5. The original form must be in possession of the driver of any private vehicle transporting unstamped cigarettes. Section 1 – Type of Sale (Check One) Stamped Cigarette Sale by Wholesaler to Unstamped Cigarette Sale by Wholesaler to Native American Retailer Native American Retailer Unstamped Cigarette Sale Wholesaler to Wholesaler Section 2 – Purchaser Information ___________________________________________________________________________________________ Business Name Retailer Authorization Number ___________________________________________________________________________________________ Name of Tribe Tribal Enrollment ID or Wholesaler License ID ___________________________________________________________________________________________ Address City State Zip ___________________________________________________________________________________________ Contact Name Social Security or FEIN Phone Section 3 – Cigarette Invoice Information Delivery Date Invoice Date Invoice ID 200 Sticks Carton 250 Sticks Carton Total Sticks Print Name of Seller or Agent Date Signature of Principal or Agent Print Name of Purchaser or Agent Date Signature of Purchaser or Agent 306

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