Form 70-015b - Iowa Department Of Revenue
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1SECTION A: GENERAL INSTRUCTIONS
Send this application, with Iowa form 70-031- proof of bond and proper remittance to:
Mailing Address:
OR
FED-EX Address:
Iowa Department of Revenue
Iowa Department of Revenue
Examination Section
Hoover Bldg., Cigarette Tax
P.O. Box 10456
1305 E Walnut
Des Moines IA 50306-0456
Des Moines IA 50319
SECTION B: NEW 601/621 CIGARETTE DISTRIBUTORS ADDITIONAL REQUIREMENTS
New cigarette distributors must enclose letters from each manufacturer that intends to sell applicant unstamped cigarettes and attach
executed bond with application. You must list all brands purchased from each manufacturer.
SECTION C: CIGARETTE ADDITIONAL REQUIREMENTS -
ONLY APPROVED BRANDS OF CIGARETTES MAY BE SOLD IN
IOWA – any brand not on the list is contraband. The list of approved brands is always current at
Any violation of contraband or non-Iowa tax stamped package is subject to seizure and penalties under the provisions of the Iowa Code 453A & 453D.
Cigarette permit applicants must answer the following questions:
1. From whom will you purchase your cigarettes? (List All – Use separate sheet if necessary)
2. To approximately how many retailers will you sell?
___________________________
3. How many of these retailers are directly affiliated with your organization?
_______________________
4. List names and addresses of your three biggest retailers.
a.
___________________________________________________________________________________________________________________________________________________
b.
___________________________________________________________________________________________________________________________________________________
c.
___________________________________________________________________________________________________________________________________________________
5. Do you maintain a warehouse for wholesale sales of cigarettes?
Yes
No
6. Will your wholesale cigarette number be printed on delivery vehicles? Yes
No
SECTION D: 603 CIGARETTE VENDOR PERMIT ADDITIONAL REQUIREMENTS
Cigarette Vendor applicants must answer the following questions:
1. Number of cigarette vending machines in use?
_______________
2. From whom do you purchase your cigarettes?
_________________________________________________________________
3. Do you have your name and address on all of your vending machines? Yes
No
4. Is the company name and permit number on all vehicles used for transporting cigarettes?
Yes
No
5. Is the location of each machine covered by a local retail permit?
Yes
No
6. List business name and location of each cigarette vending machine (provide separate list if necessary)
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If you have any questions pertaining to this application, please call the Examination Section, Cigarette Tax Unit at 515-281-8023.
70-015b
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