Form 70-015 - Annual Application For Iowa Cigarette Permit/tobacco Tax License (Page 4 of 4) in pdf

SECTION A: GENERAL INSTRUCTIONS

Send this application, with Iowa form 70-031- proof of bond and proper remittance to:

Mailing Address:

FED-EX Address:

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 & 606/626 Cigarette & Tobacco Distributor ADDITIONAL REQUIREMENTS

New cigarette AND tobacco distributors must enclose letters from each manufacturer that intends to sell applicant unstamped

cigarettes and untaxed roll your own product. You must list all brands purchased from each manufacturer. Attach Bond.

SECTION C: ADDITIONAL REQUIREMENTS -

ONLY APPROVED BRANDS OF CIGARETTES OR ROLL YOUR OWN PRODUCTS

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

ALL permit applicants must answer the following questions:

provisions of the Iowa Code 453A & 453D.

1. From whom will you purchase your cigarettes & other tobacco product? (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.

___________________________________________________________________________________________________________________________________________________

Yes 

No 

5. Do you maintain a warehouse for wholesale sales of cigarettes?

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 or OTP?

____________________________________________________________

3. Do you have your name and address on all of your vending machines? Yes 

No 

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?

6. List business name and location of each cigarette vending machine (provide separate list if necessary)

10.

11.

12.

13.

14.

If you have any questions pertaining to this application, please call the Examination Section, Cigarette Tax Unit at 515-281-8023.

70-015b

Form 70-015 - Annual Application For Iowa Cigarette Permit/tobacco Tax License Page 4

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