Form M-103 - Transfer Of Cigarette Tax Stamps Page 2
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1
2FORM M-103
(REV. 2011)
Page 2
Purpose of Form M-103
Where To Get Information and Forms
Licensees may not sell, exchange, or transfer unaffixed
Oahu District Office
Maui District Office
cigarette tax stamps without prior written approval by the
830 Punchbowl Street
54 S. High St., #208
Department of Taxation. Form M-103 is used to request
P. O. Box 259
Wailuku, HI 96793-2198
approval for the transfer of the cigarette tax stamps.
Honolulu, HI 96809-0259
Toll-Free: 1-800-222-3229
Tel. No.: (808) 587-4242
GENERAL INSTRUCTIONS
Toll-Free: 1-800-222-3229
Sections 245-21 and 245-22, Hawaii Revised Statutes (HRS),
For the hearing impaired:
provide that licensees, as defined in section 245-1, HRS,
TDD/TTY No.: (808) 587-1418
shall pay the cigarette tax through the use of cigarette tax
TDD/TTY Toll-Free: 1-800-887-8974
stamps and that licensees are required to place cigarette tax
stamps on packs of cigarettes prior to distribution, as defined
Hawaii District Office
Kauai District Office
in section 245-1, HRS.
75 Aupuni Street, #101
3060 Eiwa St., #105
Hilo, HI 96720-4245
Lihue, HI 96766-1889
SPECIFIC INSTRUCTIONS
Toll-Free: 1-800-222-3229
Toll-Free: 1-800-222-3229
Part I
Tax information and forms:
Enter information regarding the licensee transferring the
cigarette tax stamps.
Where To Send Form M-103
Part II
Form M-103 may be mailed to the Department of Taxation,
Enter information regarding the licensee receiving the cigarette
Taxpayer Services Branch, Licensing Section, P.O. Box 259,
tax stamps.
Honolulu, Hawaii, 96809-0259. After the form has been
approved or disapproved, a copy will be returned to both the
Part III
licensee transferring the cigarette tax stamps and the licensee
Enter information regarding the cigarette tax stamps being
receiving the cigarette tax stamps.
transferred.
Signatures
Form M-103 must be signed and dated by the licensee
transferring the cigarette tax stamps and the licensee receiving
the cigarette tax stamps.
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