Form M-100a - Application To Purchase Cigarette Tax Stamps Page 2
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1
2FORM M-100A
(REV. 2007)
Page 2
Purpose of Form M-100A
Where to Get Information and Forms
Oahu District Office
Maui District Office
Form M-100A is used to apply to purchase cigarette tax stamps.
830 Punchbowl Street
54 South High Street, #208
GENERAL INSTRUCTIONS
P. O. Box 259
P. O. Box 1169
Sections 245-21 and 245-22, Hawaii Revised Statutes (HRS),
Honolulu, HI 96809-0259
Wailuku, HI 96793-6169
provide that licensees, as defined in section 245-1, HRS, shall
Tel. No.: (808) 587-4242
Toll-Free: 1-800-222-3229
pay the cigarette tax through the use of cigarette tax stamps
Toll-Free: 1-800-222-3229
and that licensees are required to place cigarette tax stamps on
For the hearing impaired:
packs of cigarettes prior to distribution, as defined in section
TDD/TTY No.: (808) 587-1418
245-1, HRS.
TDD/TTY Toll-Free: 1-800-887-8974
Under section 245-22(e), HRS, the price of cigarette tax stamps
Hawaii District Office
Kauai District Office
may be reduced by a certain rate if the licensee is in compliance
75 Aupuni Street, #101
3060 Eiwa St., #105
with the State of Hawaii's tax laws. To demonstrate compliance
Hilo, HI 96720-4245
Lihue, HI 96766-1889
with the State of Hawaii's tax laws and thus be eligible for the
Toll-Free: 1-800-222-3229
Toll-Free: 1-800-222-3229
reduced cigarette tax stamp price, a tax clearance certificate
(Form A-6, Tax Clearance Application) with the State of
Tax information and forms:
Hawaii's approval must be submitted to the Department of
Taxation.
Forms By Fax/Mail:
If the licensee has a tax clearance certificate with the State of
Telephone No.: 808-587-7572
Hawaii’s approval dated within six months from the date of
Toll-Free: 1-800-222-7572
submitting Form M-100A to the Department of Taxation, the
Where to submit Form M-100A
licensee may submit a copy of that certificate in lieu of a
Mail Form M-100A to the following address:
completed Form A-6. Otherwise, the licensee shall complete
Hawaii Department of Taxation
and submit Form A-6 along with Form M-100A.
Licensing Section
Signature
P.O. Box 259
Form M-100A must be signed and dated by the cigarette tax
Honolulu, HI 96809-0259
and tobacco tax licensee.
Form M-100A
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