Form Tob-T-Agree - Agreement Which Is A Part Of The Application For Tobacco Wholesalers Permit
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1A
D
R
TOB: T-AGREE
LABAMA
EPARTMENT OF
EVENUE
7/99
S
, U
& B
T
D
ALES
SE
USINESS
AX
IVISION
T
T
S
OBACCO
AX
ECTION
P. O. Box 327555 • Montgomery, AL 36132-7555 • (334) 242-9627
Agreement Which Is A Part of The
Application For Tobacco Wholesalers Permit
In consideration of the Alabama Department of Revenue issuing us a permit as a wholesaler of
tobacco products as provided for by the Code of Alabama 1975, Section 40-25-16, on information fur-
nished the Department of Revenue by us on the attached application, we hereby agree:
To affix the required amount of Alabama tobacco revenue stamps on all tobacco products sold and
delivered to any person, firm, or corporation in Alabama; including any and all drop shipments which
may be shipped in our care for delivery to any merchant in Alabama.
To allow an inspection or an inspection and audit of our books and records at any and all reason-
able times, by an authorized representative of the Alabama Department of Revenue, for the purpose of
determining if we have fully complied with the provisions of the revenue laws of the State of Alabama.
To transport, sell, or distribute no tobacco products in Alabama which do not have affixed thereto
the required Alabama tobacco revenue stamps. (Note: Sales to National Guard Units, Military Bases,
Federal Prisons and Indian Reservations are exempt but an exemption certificate or invoice must accom-
pany shipment.)
That we will at no time pass on to any person, firm, corporation, club, or association of persons
directly or indirectly any part of the discount allowed us by the Alabama Department of Revenue on
stamp purchases.
That under no circumstances will we dispose of any Alabama tobacco revenue stamps by gift, sale,
or trade which are not affixed to tobacco products.
That any change in ownership or name automatically cancels the permit issued by the Alabama
Department of Revenue.
That any evasion or violation of this agreement or of the Alabama tobacco tax act or any rules and
regulations promulgated by the Department of Revenue automatically revokes the privileges enjoyed
under this permit.
This the _________ day of ________________________, ________.
_____________________________________________
Company Name
By __________________________________________
Officer’s Signature
_____________________________________________
Type or Print Officer’s Name and Title
Sworn to and subscribed before me this the _________ day of _______________________, ________.
____________________________________________
Notary Public
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