Form 04-620 - Cigarette Tax Stamp Order Form - Department Of Revenue Page 2
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3INSTRUCTIONS
Alaska Cigarette Tax Stamp Order Form
verified. Depending upon your method of payment,
Wire payments to:
this can take as long as two weeks.
State Street Bank & Trust Company
If you are paying for cigarette tax stamps at the time
225 Franklin Street
of purchase and the amount due is $100,000 or
Boston, Massachusetts 02110
more, you are required to make an electronic funds
ABA #011000028
transfer (EFT) or wire transfer or in accordance
For Credit to the State of Alaska - AY01
with 15 AAC 05.310.
General Investment Fund
Account #00657189
The Department of Revenue offers online electronic
funds transfer through the Tax Online Payment
Shipping Cigarette Tax Stamps
System (TOPS). This system does not require any
Cigarette tax stamps must be picked up at the Tax
pre-enrollment before using; however, you must be
Division's Anchorage office at 550 West 7th
an established taxpayer.
If you are a first time
Avenue, Suite 500 by the licensee or the licensee's
taxpayer with the State of Alaska Department of
agent or designee. Alternatively, the licensee may
Revenue, please call 907.465.2320.
Additional
request that the stamps be shipped or transported in
information and access to TOPS is located on our
a manner specified by the licensee by completing
website:
Form 04-621 and filed with the Tax Division prior
to ordering stamps. The licensee is responsible for
https://
all costs incurred to ship stamps and bears all risk of
possible loss or damage while the stamps are in
TOPS is an ACH (Automated Clearing House)
transit. A refund or credit will only be given for
Debit system. Some companies have a Debit Block
lost or damaged stamps if the shipping company
on their bank accounts. If your bank account has an
substantiates the loss or damage and damaged
ACH Debit Blocker, the TOPS payment will be
stamps are returned to the Department.
rejected by your bank unless the State of Alaska
ACH Identification number is registered with your
Signature
bank for ACH Debit processing. If you account has
Form 04-620 must be signed and dated by the
a debit block, or you suspect that it does, contract
licensee or the licensee's designee. Unsigned forms
your bank to register the State of Alaska as an
will not be accepted.
authorized ACH Debit originator before making a
payment through TOPS. The State of Alaska ACH
Where to Send Form 04-620
ID Number is 902050.
Rejected payments may
Form 04-620 may be mailed or delivered to the
result in penalties or interest.
Department of Revenue, Tax Division, 550 W. 7th
Avenue, Suite 500, Anchorage, AK 99501. It may
TOPS does not accept ACH Credit and Credit Card
also be faxed to 907.269.6644.
transactions.
For more information call your
financial institution or the Department of Revenue
Questions
Tax Division at 907.465.3776.
If you have questions about this form, please
contact the Tax Division at 907.269.6620.
To make a wire transfer, you must notify the State
of Alaska, Treasury Division at 907.465.2360 or by
FAX at 907.465.4019 regarding the particulars of
the transfer the day before the wire transfer is due.
Failure to notify the Treasury Division as required
can result in a delay in filling your stamp order.
Form 04-620 Instructions (Rev 12/04)
Page 2 of 2
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