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Vermont Department of Taxes         PO Box 547     Montpelier, VT 05601-0547                                       Phone: (802) 828-2551, option 4

                                                                                                                                        FORM
  VERMONT                     VERMONT WHOLESALE CIGARETTE DEALER REPORT
                                                                                                                                       CT-1
                           This report is due on or before the 15th of each month to cover the preceding month.

   Dealer’s Name                                                                                         Federal ID Number

   Address                                                                                               Month               Year

   City, State, ZIP Code                                                                                 State License Number

   E-mail address                                                                                        Telephone Number



PART A - STAMP INVENTORY
HEAT TRANSFER STAMPS USED                                                                                   VERMONT STAMPS
                                                                                                     20-packs            25-packs
     1. Stamps on hand at beginning of month . . . . . . . . . . . . . . . . . . . . 1. __________________ ________________
     2. Stamps purchased during the month . . . . . . . . . . . . . . . . . . . . . . 2. __________________ ________________
     3. Total (Add Lines 1 and 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. __________________ ________________
     4. Stamps affixed during the month . . . . . . . . . . . . . . . . . . . . . . . . . 4. __________________ ________________
     5. Stamps on hand at end of month . . . . . . . . . . . . . . . . . . . . . . . . . 5. __________________ ________________

DETAIL OF STAMPED PRODUCT
   6. Number of packs of cigarettes stamped during the month . . . . . 6. __________________ ________________
     7. Number of packs of little cigars stamped during the month . . . . 7. __________________ ________________

PART B - TAX DUE
NONSTAMPED LITTLE CIGARS
   8. Enter the number of INDIVIDUAL little cigars sold in Vermont during
      the month (Do NOT enter the number of packages sold) . . . . . . . . . . . . . . . . . . 8. ________________________
     9. Tax due for nonstamped little cigars (Multiply Line 8 by .0995) . . . . . . . . . . . . 9. ________________________

ROLL-YOUR-OWN TOBACCO
  10. Number of ounces of roll-your-own tobacco sold in Vermont during the month 10. ________________________
   11. Equivalent number of cigarettes (Divide Line 10 by .09) . . . . . . . . . . . . . . . . . 11. ________________________
   12. Tax due for roll-your-own tobacco (Multiply Line 11 by .0995) . . . . . . . . . . . 12. ________________________

TAX DUE
  13. Total tax due (Add Lines 9 and 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. ________________________
       Make checks payable to Vermont Department of Taxes.

  Signature                I hereby swear, under pains and penalty of perjury, that this information is true, correct, and complete to the best of
                           my knowledge.


         Signature                                                                          Title                               Date



         Printed Name

                                                                                                                                       Form CT-1
                                              For assistance, please call (802) 828-2551, option 4                                         Rev. 6/08

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- Land Gains Foreclosure Basis Form & TB

  • 1. Vermont Department of Taxes PO Box 547 Montpelier, VT 05601-0547 Phone: (802) 828-2551, option 4 FORM VERMONT VERMONT WHOLESALE CIGARETTE DEALER REPORT CT-1 This report is due on or before the 15th of each month to cover the preceding month. Dealer’s Name Federal ID Number Address Month Year City, State, ZIP Code State License Number E-mail address Telephone Number PART A - STAMP INVENTORY HEAT TRANSFER STAMPS USED VERMONT STAMPS 20-packs 25-packs 1. Stamps on hand at beginning of month . . . . . . . . . . . . . . . . . . . . 1. __________________ ________________ 2. Stamps purchased during the month . . . . . . . . . . . . . . . . . . . . . . 2. __________________ ________________ 3. Total (Add Lines 1 and 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. __________________ ________________ 4. Stamps affixed during the month . . . . . . . . . . . . . . . . . . . . . . . . . 4. __________________ ________________ 5. Stamps on hand at end of month . . . . . . . . . . . . . . . . . . . . . . . . . 5. __________________ ________________ DETAIL OF STAMPED PRODUCT 6. Number of packs of cigarettes stamped during the month . . . . . 6. __________________ ________________ 7. Number of packs of little cigars stamped during the month . . . . 7. __________________ ________________ PART B - TAX DUE NONSTAMPED LITTLE CIGARS 8. Enter the number of INDIVIDUAL little cigars sold in Vermont during the month (Do NOT enter the number of packages sold) . . . . . . . . . . . . . . . . . . 8. ________________________ 9. Tax due for nonstamped little cigars (Multiply Line 8 by .0995) . . . . . . . . . . . . 9. ________________________ ROLL-YOUR-OWN TOBACCO 10. Number of ounces of roll-your-own tobacco sold in Vermont during the month 10. ________________________ 11. Equivalent number of cigarettes (Divide Line 10 by .09) . . . . . . . . . . . . . . . . . 11. ________________________ 12. Tax due for roll-your-own tobacco (Multiply Line 11 by .0995) . . . . . . . . . . . 12. ________________________ TAX DUE 13. Total tax due (Add Lines 9 and 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. ________________________ Make checks payable to Vermont Department of Taxes. Signature I hereby swear, under pains and penalty of perjury, that this information is true, correct, and complete to the best of my knowledge. Signature Title Date Printed Name Form CT-1 For assistance, please call (802) 828-2551, option 4 Rev. 6/08