Fillable Cigaree Inventory CT201-I Minnesota Distributors (Minnesota Department of Revenue)

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Cigaree Inventory CT201-I Minnesota Distributors (Minnesota Department of Revenue)

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Minnesota Distributors
Cigaree Inventory
# of Stamps Value of Stamps
1 Stamps
Regular 20s x $ 3.673 =
Regular 25s x 4.5913 =
NaveAmerican20s x 3.673 =
NaveAmerican25s x 4.5913 =
TotalvalueofMinnesotastamps(also enter on CT201-R, line 5) .................................... 1 $
Unstamped Cigarees # of Cartons # of Cigarees
2 a.Non-feebrands(20s) x 200 = 2a
b. Feebrands(20s) x 200 = 2b
Totalcartons Totalcigarees........... 2
3 a.Non-feebrands(25s) x 200 = 3a
b. Feebrands(25s) x 200 = 3b
Totalcartons Totalcigarees........... 3
4 a.Non-feebrands(25s) x 250 = 4a
b. Feebrands(25s) x 250 = 4b
Totalcartons Totalcigarees........... 4
Other-State Stamped Cigarees
5 a.Non-feebrands(20s) x 200 = 5a
b. Feebrands(20s) x 200 = 5b
Totalcartons Totalcigarees........... 5
6 a.Non-feebrands(25s) x 200 = 6a
b. Feebrands(25s) x 200 = 6b
Totalcartons Totalcigarees........... 6
7 a.Non-feebrands(25s) x 250 = 7a
b. Feebrands(25s) x 250 = 7b
Totalcartons Totalcigarees........... 7
8 Total unstamped and other-state stamped cigarees (total of lines 2 through 7) ..................... 8
Minnesota Stamped Cigarees (includingunsaleable)
# of Cartons # of Cigarees
Regular
9 a.Non-feebrands(20s) x 200 = 9a
b. Feebrands(20s) x 200 = 9b
Totalcartons Totalcigarees ........................ 9
10 a.Non-feebrands(25s) x 200 = 10a
b. Feebrands(25s) x 200 = 10b
Totalcartons Totalcigarees ....................... 10
11 a.Non-feebrands(25s) x 250 = 11a
b. Feebrands(25s) x 250 = 11b
Totalcartons Totalcigarees ....................... 11
CT201-I
Aachment #6
Stamps
(Rev.1/21)
Licensee Address MinnesotaTaxIDNumber PeriodofReturn(mo/yr)
Connued on page 2.
Page 2 must be signed and cered by an ocer or owner.
Unstamped and Other-State StampedMinnesota Stamped
Checkifceredinventory:
Nave American
# of Cartons # of Cigarees
12 a.Non-feebrands(20s) x 200 = 12a
b. Feebrands(20s) x 200 = 12b
Totalcartons Totalcigarees.......... 12
13 a.Non-feebrands(25s) x 200 = 13a
b. Feebrands(25s) x 200 = 13b
Totalcartons Totalcigarees.......... 13
14 a.Non-feebrands(25s) x 250 = 14a
b. Feebrands(25s) x 250 = 14b
Totalcartons Totalcigarees.......... 14
15 Total Minnesota stamped cigarees (add lines 9 through 14) ..................................... 15
CT201-I (p. 2)
AuthorizedSignatureofOcerorOwner Title Date DaymePhone
Must be signed and cered by an ocer or owner.
I cerfy that the above inventory has been examined by me and is true and correct to the best of my knowledge.
Licensee Address MinnesotaTaxIDNumber PeriodofReturn(mo/yr)
Minnesota Stamped, cont.Sign Here
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Cigaree Inventory CT201-I Minnesota Distributors (Minnesota Department of Revenue)

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Completed 7 February 2021

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