<?xml version="1.0" encoding="UTF-8"?>
<!--Sample XML file generated by XMLSpy v2012 (x64) (http://www.altova.com)-->
<ReturnState stateSchemaVersion="WIExcise2010v1.0" xsi:schemaLocation="http://www.irs.gov/efile ExciseReturnWI_CT105.xsd" xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
	<ReturnHeaderState>
		<Jurisdiction>WI</Jurisdiction>
		<Timestamp>2001-12-17T09:30:47Z</Timestamp>
		<TaxPeriodBeginDate>2011-08-01</TaxPeriodBeginDate>
		<TaxPeriodEndDate>2011-08-31</TaxPeriodEndDate>
		<TaxYear>2011</TaxYear>
		<Originator>
			<EFIN>000000</EFIN>
			<OriginatorTypeCd>LargeTaxpayer</OriginatorTypeCd>
		</Originator>
		<SoftwareId>Local1</SoftwareId>
		<ReturnType>FormCT105</ReturnType>
		<Filer>
			<TIN>
				<TypeTIN>FEIN</TypeTIN>
				<TINTypeValue>012345678</TINTypeValue>
			</TIN>
			<StateEIN>999999999999999</StateEIN>
			<Name>
				<BusinessNameLine1>Test Returns LLC</BusinessNameLine1>
			</Name>
			<USAddress>
				<AddressLine1>2135 Rimrock Road</AddressLine1>
				<City>Madison</City>
				<State>WI</State>
				<ZIPCode>53708</ZIPCode>
			</USAddress>
		</Filer>
		<BusinessRepresentative>
			<Name>
				<FirstName>John</FirstName>
				<LastName>Doe</LastName>
			</Name>
			<Title>Accountant</Title>
			<Phone>6085551212</Phone>
			<EmailAddress>john.doe@SampleReturn.com</EmailAddress>
		</BusinessRepresentative>
	</ReturnHeaderState>
	<ReturnDataState>
		<FormCT105>
			<Section1>
				<BeginningInventory>1768730.04</BeginningInventory>
				<NetValueAccountedFor>9162273.96</NetValueAccountedFor>
				<TotalEndingInventory>3045601.44</TotalEndingInventory>
				<NetCredit>1607.76</NetCredit>
			</Section1>
			<Section2>
				<NetCigaretteTax>7341924.24</NetCigaretteTax>
				<TotalAmountDue>7345005.02</TotalAmountDue>
			</Section2>
			<Section3>
				<HaveMSARequirement>true</HaveMSARequirement>
			</Section3>
		</FormCT105>
		<SchCT101>
			<TypeOfSchedule>
				<TaxPaidSales>
					<InState>X</InState>
				</TaxPaidSales>
			</TypeOfSchedule>
			<Invoice>
				<LineNumber>1</LineNumber>
				<InvoiceDate>2011-08-05</InvoiceDate>
				<InvoiceNumber>00123456</InvoiceNumber>
				<Name>ABC Cigarettes</Name>
				<State>WI</State>
				<InvoiceTotalSingleCigarettes>4600</InvoiceTotalSingleCigarettes>
				<BrandFamilyDetail>
					<Manufacturer>LORILLARD</Manufacturer>
					<BrandName>Newport Non-Menthol</BrandName>
					<SingleCigarettes>1600</SingleCigarettes>
				</BrandFamilyDetail>
				<BrandFamilyDetail>
					<Manufacturer>LORILLARD</Manufacturer>
					<BrandName>Old Gold</BrandName>
					<SingleCigarettes>3000</SingleCigarettes>
				</BrandFamilyDetail>
			</Invoice>
			<Invoice>
				<LineNumber>2</LineNumber>
				<InvoiceDate>2011-08-05</InvoiceDate>
				<InvoiceNumber>00123457</InvoiceNumber>
				<Name>CBA Cigarettes</Name>
				<State>WI</State>
				<InvoiceTotalSingleCigarettes>5200</InvoiceTotalSingleCigarettes>
				<BrandFamilyDetail>
					<Manufacturer>PHILIP MORRIS USA</Manufacturer>
					<BrandName>Basic</BrandName>
					<SingleCigarettes>3800</SingleCigarettes>
				</BrandFamilyDetail>
				<BrandFamilyDetail>
					<Manufacturer>PHILIP MORRIS USA</Manufacturer>
					<BrandName>L&amp;M Discount</BrandName>
					<SingleCigarettes>1400</SingleCigarettes>
				</BrandFamilyDetail>
			</Invoice>
			<GrandTotal>9800</GrandTotal>
		</SchCT101>
		<SchCT104>
			<BeginningInventory>
				<Regular25s>637</Regular25s>
				<Regular20s>101309</Regular20s>
				<GrossValueOfStamps>257305.23</GrossValueOfStamps>
			</BeginningInventory>
			<Item>
				<LineNumber>2</LineNumber>
				<DateReceived>2011-08-05</DateReceived>
				<IssueDate>2011-08-19</IssueDate>
				<PrintingCosts>499.50</PrintingCosts>
				<StampDenominations>
					<Regular20s>555000</Regular20s>
					<GrossValueOfStamps>1398600</GrossValueOfStamps>
				</StampDenominations>
			</Item>
			<TotalPrintingCosts>499.50</TotalPrintingCosts>
			<Total>
				<Regular20s>555000</Regular20s>
				<GrossValueOfStamps>1398600</GrossValueOfStamps>
			</Total>
			<NetAvailable>
				<Regular25s>637</Regular25s>
				<Regular20s>656309</Regular20s>
				<GrossValueOfStamps>1655905.23</GrossValueOfStamps>
			</NetAvailable>
			<EndingInventory>
				<Regular25s>637</Regular25s>
				<Regular20s>139509</Regular20s>
				<GrossValueOfStamps>353569.23</GrossValueOfStamps>
			</EndingInventory>
		</SchCT104>
		<SchCT118>
			<SalableStockOnPremise>5854200</SalableStockOnPremise>
			<UnsalableStock>96120</UnsalableStock>
			<OffPremiseStorage>0</OffPremiseStorage>
			<SalespersonsVehicle>0</SalespersonsVehicle>
			<DeliveryTrucks>0</DeliveryTrucks>
			<OtherStock>0</OtherStock>
			<VendingMachineLocations>0</VendingMachineLocations>
			<NumberVendingMachines>0</NumberVendingMachines>
			<StockInVendingMachines>0</StockInVendingMachines>
			<TotalStampedInventory>5950320</TotalStampedInventory>
			<TotalReturned>0</TotalReturned>
		</SchCT118>
	</ReturnDataState>
</ReturnState>
