Free CG-114-I (Instructions) - New York

New York State Department of Taxation and Finance

Instructions for Form CG-114
Claim for Redemption/Refund of Cigarette Tax Stamps and Prepaid Sales Tax
When to file
An agent must submit all applications for redemption/refund of the New York State cigarette tax within two years after the cigarette tax stamps were affixed or the unused stamps were purchased. A retail dealer or wholesale dealer must apply for a New York State refund of the face value of the stamps within two years after purchasing the stamped packages of cigarettes from a licensed stamping agent. All applications for refund of the New York State prepaid sales tax must be filed within three years from the time the stamps were purchased. Keep a copy of your claim form and all supporting documentation for a period of three years.

CG-114-I

(6/09)

Stamping agents may be entitled to a refund of the face value of the stamps, less any commissions allowed. When determining the rate of commission to be used in computing the net amount of refund allowed, if an agent cannot establish the date of purchase of the affixed stamps, the rate or rates in effect at the time of the sale, destruction, or determination of unsuitability may be used with the prior consent of the Tax Department. To contact the Tax Department see Need help? on page 3. Retail dealers or wholesale dealers may be entitled to a refund of the face value of the stamps. However, if a retail dealer or wholesale dealer returns cigarettes to its supplying agent for a credit, the retail dealer or wholesale dealer should not file a refund claim.

Cigarettes returned to the manufacturer
Where a manufacturer will accept the return of unsalable cigarettes, you may file a claim for refund if the manufacturer will provide you with a statement or affidavit that certifies the stamped cigarettes were returned and the tax has not been reimbursed. Submit a separate refund claim for each manufacturer to whom stamped cigarettes will be returned. Prior to returning any stamped packages of cigarettes to the manufacturer you must: · havethepackagesinspectedandverified(seeProcedure for inspection and verification, below), or · receivewrittenauthorizationfromtheTaxDepartmenttoreturn the product without inspection. Once the inspection and verification are complete or you have receivedwrittenauthorization,youmaymakearrangementsto return the cigarettes to the manufacturer. Submit the manufacturer's statement or affidavit with your original claim to the Tax Department.

How to file for reimbursement of the New York City cigarette tax
To receive a copy of the New York City refund application or to request information on the reimbursement/refund of the New York City cigarette tax, contact the City of New York, Department of Finance, 345 Adams Street, 13th Floor, Brooklyn NY 11201.

Part 1 -- Claim for redemption of unused or damaged cigarette tax stamps and prepaid sales tax ­ Stamping agents only
You may file a claim for redemption with respect to unaffixed stamps that: · younolongerneedorarenolongerqualifiedtoaffix, · arefromyourinventoryifyouareinliquidation, · aresodamagedastobeworthlessorunfitforuse, · havebeensupersededbystampsofanewdesignor denomination, or · theTaxDepartmentdeemsappropriateforredemption. The amount of redemption allowed will be the amount of cigarette tax actually paid (the face value of stamps you purchased, less commissions retained by you). You must send Form CG-114 by registered mail to the Tax Department together with all unused or damaged stamps for which you are claiming redemption. However, if registered mail is not feasible due to the volume of stamps to be redeemed, you may use a private delivery service. See Private delivery services on page 3.

Agent destruction of cigarettes
If the manufacturer will not accept unsalable cigarettes, agents may destroy these cigarettes after: · inspectionandverification(seeProcedure for inspection and verification, below), or · receiptofwrittenauthorizationfromtheTaxDepartmenttoreturn the product without inspection. Once the inspection and verification are complete or you have receivedwrittenauthorization,youmaymakearrangementstohave the cigarettes destroyed.

Procedure for inspection and verification
Upon receipt of notice of your refund claim, a Tax Department representative will contact you to arrange a mutually convenient appointment for the inspection of the stamped packs and the verification of your claim. The packages must be sorted separately by jurisdiction (State only or Joint City and State stamps) then by stamp color and design. When you submit your claim, attach a list of the total number of packages being returned, by stamp color and design, as well as a sample of serial numbers for each stamp color and design. Allow a sufficient area for the Tax Department's representative to perform the inspection.

Part 2 -- Claim for refund for stamps affixed to packages of cigarettes and prepaid sales tax
Stamping agents, wholesale dealers, and retail dealers should use Part 2 to claim a refund of the New York State cigarette tax and the prepaid sales tax for stamps affixed to packages of cigarettes that were: · returnedtothemanufacturer, · unsalableorunfitforuseandconsumption, · destroyedorsenttotheTaxDepartmentfordestruction, · soldoutsideofthestate,or · soldtoanexemptpurchaser

Cigarettes sent to the Tax Department for destruction
When a manufacturer or agent will not accept returns of cigarettes that are unsalable or are unfit for use and consumption, wholesale dealers and retail dealers may send these cigarettes to the Tax Department for destruction. Sort the cigarettes by jurisdiction (State only or Joint City and State stamps) then by stamp color and design. If the packages are loose, put them in cartons and pack the cartons in a box. Attach to your refund claim copies of invoices showing

Page 2 of 3 CG-114-I (6/09)
purchases of the specific brands being returned and the cigarette tax and prepaid sales tax paid. Note: If the number of packs of cigarettes exceeds 5,000, do not send the cigarettes to the Tax Department. Send only the refund claim and your purchase invoices. A Tax Department representative will contact you to make inspection and verification arrangements. See Procedure for inspection and verification on page 1.

Column B -- Prepaid sales tax per pack
The prepaid sales tax on cigarettes is required to be paid at the time cigarette stamps are purchased. Use the appropriate prepayment amounts from the updated chart below to complete Column B. Date stamps were purchased 6/1/05 through 8/31/08 9/1/08 through 5/31/09 6/1/09 through 8/31/09 20 packs 36¢ 37¢ 42¢ 25 packs 45¢ 47¢ 53¢

Cigarettes sold outside of the state
When the refund claim is for the value of stamps affixed to packages that have been sold outside of the state, a statement for each invoice acknowledging receipt of packages of cigarettes, signed by the out-of-state purchaser, must accompany the claim. In addition, this statement must include the date prepared, the name and address of both the purchaser and the seller, the purchaser's identification number, the out-of-state location where the cigarettes will be taken, and certification that they will not be returned to New York State for sale or use. The department may require further information or proof of the application for refund or redemption as it may deem necessary for the processing of the application. No refund or redemption will be paid unless the department is satisfied that the amount of tax for which the refund or redemption is claimed has actually been collected by or on behalf of New York State. Important: the stamps must be obliterated or otherwise voided before the cigarettes are shipped to the out-of-state purchaser. Note: Change of possession of the cigarettes must take place outside New York State. If an out-of-state dealer, or his or her agent, takes possession of the cigarettes inside New York State, it is a taxable sale and no refund of tax is allowed.

Column C -- Number of stamps
Part 1 -- Enter the number of tax stamps purchased. List separately accordingtothedateofpurchaseandpacksize. Part 2 -- Enter the number of affixed stamps on packs of cigarettes you purchased. List separately according to the date of purchase andpacksize.

Column D -- Cigarette tax paid
Multiply the cigarette tax stamp denomination in Column A by the number of cigarette stamps in Column C, and enter the result. If you are not a cigarette stamping agent, do not complete Columns E or F; go to Column G.

Column instructions for Parts 1 and 2
The redemption/refund of the cigarette tax and/or prepaid sales tax is based on the rates in effect at the time the payment for the stamps was made. Therefore, complete Parts 1 and 2, starting with the date stamps were purchased and making subsequent entries in Column A (if applicable; see Column A instructions and chart below) through Column H, as applicable, based on the purchase date of the stamps that you entered on each line in the first column.

Column E -- Commission rate
Stamping agents only: In Parts 1 and 2, enter the commission rate that was received for affixing the tax stamps that corresponds to the date the stamps were purchased from the bank.

Column F -- Commission amount
Multiply the cigarette tax paid in Column D by the commission rate in Column E, and enter the result.

Column A -- Cigarette tax stamp denomination
Column 1 of the chart below includes information on the cigarette tax denominations that are eligible for redemption/refund, and that are preprinted in Column A of Parts 1 and 2. Columns 2 and 3 of the chart below can assist in identifying the appropriate cigarette tax denomination (Column A of Parts 1 and 2, on Form CG-114) based on the number of cigarettes in the pack and whether the cigarettes were sold in New York State (outside New York City) or in New York City.

Column G -- Cigarette tax paid less commission
If you are not a cigarette stamping agent, enter the cigarette tax paid from Column D. Stamping agents only: Subtract the commission amount in Column F from the cigarette tax in Column D, and enter the result.

Column H -- Prepaid sales tax paid
Multiply the prepaid sales tax per pack in Column B by the number of stamps in Column C, and enter the result. If you claimed the prepaid sales tax as a credit on your sales tax return, do not enter it in Column H.

Column 1

Column 2

Column 3

Cigarette tax stamp denomination
For cigarette tax stamps purchased on or after June 3, 2008
(preprinted in Column A of Parts 1 and 2 )

Number of cigarettes

Locale for sale of cigarettes

per pack
20 20 21 - 25 21 - 25 NY State (outside NYC) New York City NY State (outside NYC) New York City

$2.75 $2.75 $3.4375 $3.4375

state joint state joint

CG-114-I (6/09) Page 3 of 3

Certification
Sign the required certification. Please read the certification carefully before signing.

Mailing address
Mail your claim form along with any required stamps, coupons, invoices, manufacturer's statements or affidavits, or unsalable cigarettes that you could not return to the manufacturer to:
NYS TAx DEPARTMENT TTTB FACCTS -- CIGARETTE TAx UNIT W A HARRIMAN CAMPUS ALBANY NY 12227

Privacy notification -- The Commissioner of Taxation and Finance may collect and maintain personal information pursuant to the New York State Tax Law, including but not limited to, sections 5-a, 171, 171-a, 287, 308, 429, 475, 505, 697, 1096, 1142, and 1415 of that Law; and may require disclosure of social security numbers pursuant to 42 USC 405(c)(2)(C)(i). This information will be used to determine and administer tax liabilities and, when authorized by law, for certain tax offset and exchange of tax information programs as well as for any other lawful purpose. Information concerning quarterly wages paid to employees is provided to certain state agencies for purposes of fraud prevention, support enforcement, evaluation of the effectiveness of certain employment and training programs and other purposes authorized by law. Failure to provide the required information may subject you to civil or criminal penalties, or both, under the Tax Law. This information is maintained by the Manager of Document Management, NYS Tax Department, W A Harriman Campus, Albany NY 12227; telephone (518) 457-5181.

Note: If cigarette stamps are included with this claim, use registered mail. Private delivery services -- If you choose, you may use a private delivery service, instead of the U.S. Postal Service, to mail in your form and tax payment. However, if, at a later date, you need to establish the date you filed or paid your tax, you cannot use the date recorded by a private delivery service unless you used a delivery service that has been designated by the U.S. Secretary of the Treasury or the Commissioner of Taxation and Finance. (Currently designated delivery services are listed in Publication 55, Designated Private Delivery Services. See Need help? below for information on obtaining forms and publications.) If you have used a designated private delivery service and need to establish the date you filed your form, contact that private delivery service for instructions on how to obtain written proof of the date your form was given to the delivery service for delivery.

Need help?
Internet access: www.nystax.gov (for information, forms, and publications) Fax-on-demand forms: Forms are available 24 hours a day, 7 days a week. 1 800 748-3676 Telephone assistance is available from 8:00 A.M. to 5:00 P.M. (eastern time), Monday through Friday. Miscellaneous Tax Information Center: (518) 457-5735 For in-state callers without free long distance: 1 800 470-4353 To order forms and publications: For in-state callers without free long distance: (518) 457-5431 1 800 462-8100 Text Telephone (TTY) Hotline (for persons with hearing and speech disabilities using a TTY): If you have access to a TTY, contact us at 1 800 634-2110. If you do not own a TTY, check with independent living centers or community action programs to find out where machines are available for public use. Persons with disabilities: In compliance with the Americans with Disabilities Act, we will ensure that our lobbies, offices, meeting rooms, and other facilities are accessible to persons with disabilities. If you have questions about special accommodations for persons with disabilities, call the information center.