Form 08-4181 - Alaska Business License Application (Page 2 of 2) in pdf

Form 08-4181 - Alaska Business License Application Page 2

TOBACCO ENDORSEMENT

Complete the section below if your business will sell tobacco products. You must obtain a tobacco endorsement for each

location or outlet where tobacco products are sold. The fee is $100.00 for each endorsement in addition to the business

license fee. The tobacco endorsement(s) will expire on the same date as the business license and are renewable.

A sign that reads: “The sale of tobacco products to persons under the age 19 is illegal” will be mailed and must be displayed at

each location where tobacco is sold. This sign must be displayed in a conspicuous location to a person purchasing or

consuming tobacco products. There are significant penalties for improper sales of tobacco products. It is the licensee’s

responsibility to be familiar with the proper sales of tobacco.

List the physical address of each location tobacco products will be sold:

Business Name (Must be the same as listed on Business License Application):

1. Physical address where tobacco will be sold:

City:

State: AK

Zip Code:

2. Physical address where tobacco will be sold:

City:

State: AK

Zip Code:

3. Physical address where tobacco will be sold:

City:

State: AK

Zip Code:

4. Physical address where tobacco will be sold:

City:

State: AK

Zip Code:

5. Physical address where tobacco will be sold:

City:

State: AK

Zip Code:

6. Physical address where tobacco will be sold:

City:

State: AK

Zip Code:

Copy this form or attach additional pages to purchase more tobacco endorsements.

08-4181.doc(Rev. 07/27/09)

Form 08-4181 - Alaska Business License Application Page 2