Tobacco Tax Forms & Schedules

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Many tax forms can now be completed on-line for printing and mailing. Currently, there is no computation, validation, or verification of the information you enter, and you are still responsible for entering all required information. Instructions may require some information to be handwritten on the form (signatures, for example).

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You will need Adobe Acrobat Reader installed to view the tax forms listed below.

 

Electronic Filing - Effective April 2005

 

Form Number	Form Name
4028	Schedule M - Bad Debt Deduction
4241	Tobacco Products Payment Proposed Adjustment Coupon
4855	Monthly PACT Act - Cigarette (Traditional and RYO) Sales Report
4856	Monthly PACT Act - Smokeless Tobacco Sales Report
5746	Monthly PACT Act - Cigarette (ENDS) Sales Report
5747	Monthly PACT Act - Cigarette (Little Cigars) Sales Report

 

Application/License Information

 

Form Number	Form Name
151	Authorized Representative Declaration (Power of Attorney)
337	Tobacco Tax License Application Instructions
4857	Tobacco Manufacturer's Representative Permission List
5575	Tobacco Tax License Application Signature Page
702	Motor Fuel/Tobacco Surety Bond

 

Tobacco Purchases via the Internet

 

4096C	Michigan Tobacco Products Tax Return for Untaxed Cigarettes, Premium Cigars and Other Tobacco Products Purchased November 1, 2012, through October 31, 2021

 

Tobacco Stamping

 

Form Number	Form Name
323	Application for Other Tobacco Products Stamp
3371	Stamping Agent Agreement
3383	Damaged Cigarette Stamp Returns
5191	Application for Compensation for Certain Upgrades to Cigarette Tax Stamping Technology and Equipment
5210	Application for Compensation for Purchases of Certain Cigarette Case Packers and/or Conveyors by Eligible Stamping Agents

Tribal

 

Form Number	Form Name
3592	Claim for Tobacco Tax Refund
3593	Summary of Sales Worksheet/Tribal Government or Tribal Members
3598	Indian Country Information Inquiry

 

Non-Participating Manufacturer

 

Form Number	Form Name
3762	2021 Quarterly Certification of Compliance by Nonparticipating Manufacturer (NPM)
4126	Equity Assessment Prepayment Report for Non-Participating Manufacturers (NPM) of Cigarettes and/or Roll Your Own Tobacco
5465	2021 Quarterly Statement of Deposit by Nonparticipating Manufacturer (NPM)
5531	2020 Annual Certification of Compliance by Nonparticipating Manufacturer (NPM)
5532	Annual Reconciliation for 2020 Escrow Deposit