Fillable Tobacco Tax Remittance Form

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Tobacco Tax Remittance Form

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CITY OF LEEDS
Monthly Tobacco Tax Return
1040 Park Drive
Leeds, AL 35094
PHONE - 205-699-2585 FAX - 205-699-6558
CITY OF LEEDS
Monthly Tobacco Tax Return
1040 Park Drive
Leeds, AL 35094
PHONE - 205-699-2585 FAX - 205-699-6558
January
AugustJuly
February March
OctoberSeptember
April May
DecemberNovember
June
Cigars (of any type),
sold
individually
$0.03/Cigar
Cigars (of any type),
sold
in a package
$0.10/Pack
Cigarettes
$0.10/Pack
Chewing Tobacco
$0.10/Pack
Snuff Can
$0.10/Can
Smoking Tobacco
$0.10/Pack
Amount Due
Sales
Tax Due
Penalty & Interest (if applicable)
Total Amount Due and Enclosed
Business Name: Account Number:
For the Month of:
January February
AugustJuly
March
September
April
October
Year:
May
November December
June
Year:
Cigars (of any type),
sold
individually
$0.03/Cigar
Cigars (of any type),
sold
in a package
$0.10/Pack
Cigarettes
$0.10/Pack
Chewing Tobacco
$0.10/Pack
Snuff Can
$0.10/Can
Smoking Tobacco
$0.10/Pack
Amount Due
Sales
Tax Due
I declare, under penalties of perjury, that this return and any accompanying schedules have
been examined by me and to the best of my knowledge is true, correct and complete.
Email:
FEIN:Date:
Telephone #:Print Name:
Signature:
This return along with payment must be received or postmarked by the 20th day of the month
following the reporting period for which you are filing to be considered a timely return.
I declare, under penalties of perjury, that this return and any accompanying schedules have
been examined by me and to the best of my knowledge is true, correct and complete.
Signature: Date: FEIN:
Print Name: Telephone #: Email:
Business Name: Account Number:
Penalty & Interest (if applicable)
Total Amount Due and Enclosed
This return along with payment must be received or postmarked by the 20th day of the month
following the reporting period for which you are filing to be considered a timely return.
For the Month of:
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Tobacco Tax Remittance Form

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Completed 14 July 2020

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