<?xml version="1.0" encoding="UTF-8"?>
<!--Sample XML file generated by XMLSpy v2018 sp1 (x64) (http://www.altova.com)-->
<ReturnState xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
	<SubmissionId>00000000012018080t01</SubmissionId>
	<ReturnHeaderState>
		<Jurisdiction>WI</Jurisdiction>
		<Timestamp>2018-03-21T09:30:47Z</Timestamp>
		<TaxPeriodBeginDate>2018-02-01</TaxPeriodBeginDate>
		<TaxPeriodEndDate>2018-02-28</TaxPeriodEndDate>
		<TaxYear>2019</TaxYear>
		<SoftwareId>XMLSpy</SoftwareId>
		<SoftwareVersion>1</SoftwareVersion>
		<InternetProtocol>
			<IPAddress>
				<IPv4AddressTxt>0.0.0.0</IPv4AddressTxt>
			</IPAddress>
			<IPTimestamp>2001-12-17T09:30:47Z</IPTimestamp>
		</InternetProtocol>
		<SignatureOption>
			<SignatureDocument>Mail</SignatureDocument>
		</SignatureOption>
		<AmendedReturnIndicator>X</AmendedReturnIndicator>
		<OriginalSubmissionId>00000000012018079t01</OriginalSubmissionId>
		<OriginalSubmissionDate>2018-03-20</OriginalSubmissionDate>
		<ReturnType>FormTT100</ReturnType>
		<Filer>
			<EIN>000000000</EIN>
			<StateEIN>411000000000107</StateEIN>
			<Name>
				<BusinessNameLine1Txt>Sample Tobacco Business</BusinessNameLine1Txt>
				<BusinessNameLine2Txt>Joes Tobacco</BusinessNameLine2Txt>
			</Name>
			<USAddress>
				<AddressLine1Txt>2135 Rimrock Rd</AddressLine1Txt>
				<CityNm>Madison</CityNm>
				<StateAbbreviationCd>WI</StateAbbreviationCd>
				<ZIPCd>53708</ZIPCd>
			</USAddress>
		</Filer>
		<BusinessRepresentative>
			<PersonName>
				<FirstName>Joe</FirstName>
				<LastName>Tester</LastName>
			</PersonName>
			<PersonTitleTxt>Cheif Tester</PersonTitleTxt>
			<PhoneNum>6085551212</PhoneNum>
			<EmailAddressTxt>Joe.Tester@joetester.com</EmailAddressTxt>
		</BusinessRepresentative>
	</ReturnHeaderState>
	<ReturnDataState>
		<FormTT100>
			<TobaccoProductsTax>40202.54</TobaccoProductsTax>
			<TaxReconciliation>
				<TotalAmtDue>40202.54</TotalAmtDue>
			</TaxReconciliation>
			<HaveMSARequirement>No</HaveMSARequirement>
		</FormTT100>
		<SchTransaction>
			<Schedule>
				<TypeOfSchedule>1A</TypeOfSchedule>
				<TransactionDocument>
					<Date>2018-02-01</Date>
					<TypeOfTransDoc>Invoice</TypeOfTransDoc>
					<DocNumber>2607201</DocNumber>
					<TypeOfCustomer>Customer</TypeOfCustomer>
					<Name>
						<BusinessNameLine1Txt>Ida Knows Tobacco</BusinessNameLine1Txt>
					</Name>
					<Address>
						<USAddress>
							<AddressLine1Txt>123 Test Street</AddressLine1Txt>
							<CityNm>Testerville</CityNm>
							<StateAbbreviationCd>WI</StateAbbreviationCd>
							<ZIPCd>54321</ZIPCd>
						</USAddress>
						<TypeOfAddress>Mailing</TypeOfAddress>
					</Address>
					<EIN>000000001</EIN>
					<StateEIN>411000000000107</StateEIN>
					<CustomerID>a1</CustomerID>
					<Transactions>
						<FedDesc>Pipe Tobacco</FedDesc>
						<StateDesc>WI-OTP1</StateDesc>
						<MSAStatus>NPM</MSAStatus>
						<Price>999.99</Price>
						<TaxJurisdiction>WI</TaxJurisdiction>
						<ProductDescription>Joes Pipe Tobacco</ProductDescription>
						<Manufacturer>Big Joe</Manufacturer>
						<ManufacturerEIN>000000003</ManufacturerEIN>
						<BrandFamily>Blue Sheep</BrandFamily>
						<Unit>0</Unit>
						<UnitDescription>BUL</UnitDescription>
						<WeightVolume>0</WeightVolume>
						<Value>999.99</Value>
						<Quantity>0</Quantity>
						<StickCount>0</StickCount>
						<ExtendedTaxableAmount>999.99</ExtendedTaxableAmount>
					</Transactions>
					<Transactions>
						<FedDesc>Chewing Tobacco</FedDesc>
						<StateDesc>WI-MS1</StateDesc>
						<MSAStatus>NPM</MSAStatus>
						<Price>12.30</Price>
						<TaxJurisdiction>WI</TaxJurisdiction>
						<ProductDescription>Jims Chewing Tobacco</ProductDescription>
						<Manufacturer>Big Jim</Manufacturer>
						<ManufacturerEIN>000000003</ManufacturerEIN>
						<BrandFamily>Blue Bull</BrandFamily>
						<Unit>12</Unit>
						<UnitDescription>TIN</UnitDescription>
						<WeightVolume>12.05</WeightVolume>
						<Value>245.55</Value>
						<Quantity>12</Quantity>
						<ExtendedTaxableAmount>678.98</ExtendedTaxableAmount>
					</Transactions>
				</TransactionDocument>
			</Schedule>
		</SchTransaction>
		<SchTT117>
			<BadDebt>
				<LineNumber>1</LineNumber>
				<InvoiceDate>2018-02-03</InvoiceDate>
				<InvoiceNumber>117B123</InvoiceNumber>
				<Name>Sample Name</Name>
				<Address>
					<USAddress>
						<AddressLine1Txt>123 Test Lane</AddressLine1Txt>
						<CityNm>Testerville</CityNm>
						<StateAbbreviationCd>WI</StateAbbreviationCd>
						<ZIPCd>54321</ZIPCd>
					</USAddress>
				</Address>
				<TIN>
					<TypeTIN>FEIN</TypeTIN>
					<TINTypeValue>000000008</TINTypeValue>
				</TIN>
				<TypeOfCustomer>Retailer</TypeOfCustomer>
				<WriteOffDate>2018-02-02</WriteOffDate>
				<TobaccoProductsManListPrice>150.00</TobaccoProductsManListPrice>
				<TaxRate>1.00</TaxRate>
				<UncollectibleTobaccoProdTax>12.00</UncollectibleTobaccoProdTax>
			</BadDebt>
			<TotalUncollectibleTax>12.00</TotalUncollectibleTax>
		</SchTT117>
	</ReturnDataState>
</ReturnState>
