Cigarette Wholesalers & Other Tobacco Wholesalers, Cigarette Importer, Cigarette Manufacturer License Application (Page 2 of 5) in pdf

Cigarette Wholesalers & Other Tobacco Wholesalers, Cigarette Importer, Cigarette Manufacturer License Application Page 2

NOTICE TO WYOMING LICENSED TOBACCO WHOLESALERS

This is a joint notice from the Wyoming Department of Revenue Excise Tax Division and the

Wyoming Attorney General’s Office Tobacco Settlement Unit.

Wyo. Stat. § 39-18-106(a), states in part:

Every wholesaler who sells or offers to sell cigarettes, cigars,

snuff or other tobacco products in this state must have a

license to do so issued by the department.

No license or

renewal of a license shall be granted under this section unless

the wholesaler states in writing, under penalty of false

swearing, that he shall comply fully with W.S. 9-4-1201

through 9-4-1209.

Of specific note is W.S. 9-4-1207, which requires every Wyoming licensed tobacco wholesaler to

file by the 20

of each month following the month of sales the form titled: Wyoming Cigarette and

Roll-Your-Own Tobacco Wholesaler Report. This report pertains only to sales of cigarettes and

roll-your-own tobacco products. The report might be non-applicable to your operation, if you deal

only in cigars or pipe tobacco, but because you hold a wholesale license that allows you to deal in

cigarette and roll-your-own tobacco product at any time, you must file the report with the Tobacco

Settlement Unit of the Attorney General’s Office, not the Department of Revenue.

Signing this form attests to the Department of Revenue your compliance with W.S. 9-4-1201

through 9-4-1209. Once signed, return this form to the Department of Revenue on or before the

stipulated deadline.

I certify, under penalty of false swearing, that I have read this form, and that I shall fully comply

with W.S. 9-4-1201 through 9-4-1209, as it pertains to responsibilities of a Wyoming licensed

tobacco wholesaler.

______________________________________________________________________________

Name of Wholesaler

License #

______________________________________________________________________________

Address (City, State, Zip)

______________________________________________________________________________

Signature of Authorized Representative

Date

______________________________________________________________________________

Printed Name of Authorized Representative and Title

Return this form to:

Department of Revenue

Excise Tax Division

Herschler Bldg., 2

Floor West

Deadline: Must be submitted

Cheyenne, WY 82002

with license application.

Fax - 307-777-3632

For information from the Tobacco Settlement Unit, contact: Lesley Osen at 307-777-5833

Cigarette Wholesalers & Other Tobacco Wholesalers, Cigarette Importer, Cigarette Manufacturer License Application Page 2

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