Form 08-4181 - New Alaska Business License Application Page 2
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TOBACCO ENDORSEMENT
In accordance with Alaska Statute 43.70.075
Complete this form if your business will sell tobacco products. New tobacco
endorsements must initially apply by hardcopy (paper) application. Online filing
OFFICE USE ONLY
is not available at this time for the purchase of a new tobacco endorsement.
A tobacco endorsement is required for each location or outlet where tobacco products are sold.
A tobacco endorsement cannot stand on its own: it must be attached to a business license.
Tobacco Endorsement Fee(s): $100 per location in addition to the business license fee.
EXPIRATION DATE: Tobacco endorsements will expire on the same date as the business license to which they are attached.
Tobacco endorsements must be renewed at the same time as the business license to which they are attached.
REQUIRED SALE OF TOBACCO SIGNAGE: A “The sale of tobacco products to persons under the age 19 is illegal” sign will
be mailed to you with your business license 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 exact same name as listed on the Alaska Business License Application):
Location #1: Physical location where tobacco will be sold:
City:
State: AK
Zip Code:
FEE: $100.
(Fees are nonrefundable once the license and endorsement has been issued.)
Location #2: Physical location where tobacco will be sold:
City:
State: AK
Zip Code:
FEE: $100.
(Fees are nonrefundable once the license and endorsement has been issued.)
Location #3: Physical location where tobacco will be sold:
City:
State: AK
Zip Code:
FEE: $100.
(Fees are nonrefundable once the license and endorsement has been issued.)
Location #4: Physical location where tobacco will be sold:
City:
State: AK
Zip Code:
FEE: $100.
(Fees are nonrefundable once the license and endorsement has been issued.)
Location #5: Physical location where tobacco will be sold:
City:
State: AK
Zip Code:
FEE: $100.
(Fees are nonrefundable once the license and endorsement has been issued.)
Copy this form or attach additional pages to purchase more tobacco endorsements.
New tobacco endorsements must apply by hardcopy. Online filing is not available for the purchase of a new tobacco
endorsement.
08-4181 (Rev. 08/21/13)
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