Cigarette Dealer'S License Renewal Application Form - 2011-2012 printable pdf download

Cigarette Dealer'S License Renewal Application Form - 2011-2012

STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS

Department of Revenue

DIVISION OF TAXATION

Excise Tax Section

One Capitol Hill

Providence, RI 02908-5800

Fax (401) 574-8914

IMPORTANT NOTICE

CIGARETTE DEALER’S LICENSE RENEWAL APPLICATION

July 1, 2011 - June 30, 2012

Section 44-20-5 of the Rhode Island General Laws requires that all cigarette dealer licenses be renewed

annually at a cost of $25.00. The law states that the renewal application must be filed by February 1

each year, renewing the license for the fiscal year beginning July 1

If you do not intend to be in business after July 1, 2011, or have already ceased doing business, please

check number 1 below indicating the date you stopped selling cigarettes and return the license to the

Division of Taxation. If you intend to be in business after July 1, 2011, your license must be renewed and

you should check number 2 below and return the bottom payment voucher along with a check for $25.00

to the Division of Taxation.

Chapter 76 of Title 5 and Chapter 3 of Title 31 of the Rhode Island General Laws as amended provide

that a business may not renew a license or permit to conduct a business unless all of its state taxes are

paid or it has entered into a written time payment agreement, satisfactory to the Tax Administrator, to pay

all outstanding state taxes. Therefore, if you wish to renew your cigarette dealer license and you are not

in good standing with regard to your state taxes you should contact Collections at (401)574-8941 Monday

through Friday between the hours of 8:30am and 4:00 pm to resolve this issue.

DETACH HERE

CIGARETTE DEALERS LICENSE RENEWAL

PAYMENT VOUCHER

TAXPAYER:

_______________________________

DATE:

_______________________

ADDRESS:

_______________________________ TAX ID: _______________________

_______________________________

______ 1. Please cancel my cigarette dealer license as of ______________ (date)

______ 2. Enclosed is my check for $25.00 to renew my license for 2011/2012

______ 3. I have enclosed my delinquent return(s) and the balance due of $_____________

_____________________________________________

________________________

TAXPAYER SIGNATURE

TITLE

DATE

TDD (401) 574-8934 (Telecommunication Device for the Deaf)

Cigarette Dealer'S License Renewal Application Form - 2011-2012