Form Cg-100-C - Checklist For Applications Cg-100-A, Cg-100-W, And Cg-100-V

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CG-100-C
New York State Department of Taxation and Finance
(2/12)
Checklist for Applications CG-100-A, CG-100-W, and CG-100-V
Article 20 of the Tax Law
Before sending the application, make sure that you have enclosed the following items. Your application
cannot be processed until all of the appropriate forms, attachments, and fees are submitted to the
New York State Tax Department.
Applicants for an agent or agent/wholesale dealer license must complete Form CG-100-A,
Application for License as a Cigarette Agent or Agent/Wholesaler. Applicants for a wholesale
dealer license, other than a vending machine operator, must complete Form CG-100-W,
Application for License as a Wholesale Cigarette Dealer Other Than Those Who Only
Operate Vending Machines. Applicants who only operate vending machines must complete
Form CG-100-V, Application for License as a Wholesale Cigarette Dealer Who Only Operates
Vending Machines.
The nonrefundable application fee must be in the form of a bank check, certified check, money
order, or other guaranteed draft. We cannot accept uncertified personal or business checks for
payment of the cigarette license application fee. The fees are as follows:
Wholesale dealer who only operates vending machines
$-0-
Agent only or wholesale dealer only
$1,500
Agent and wholesale dealer
$3,000
If you paid the application fee within the preceding 12 months, the fee is $1,000 (instead of
$1,500) or $2,000 (instead of $3,000). There is no fee required for agents and wholesale dealers
who are currently licensed and are only adding locations.
Copy of the organizational documents (for example, partnership agreement, or a certificate
of incorporation) if the applicant is not a natural person. If the applicant is a foreign or alien
corporation, also submit a copy of: 1) the Application for Authority filed with the New York State
Secretary of State, and 2) the official filing receipt issued by the New York State Secretary of
State.
Copy of a lease or deed for the warehouse and stamping location(s) listed on the application.
When you enter into a lease, it must be for a minimum of two years. You must include a completed
Form CG-100-L, Cigarette Agent/Wholesaler-Lessor Identification, for each stamping or
warehouse location that the applicant does not own.
Reviewed or audited financial statements prepared by an independent certified public accountant
or licensed public accountant for a period that ended not more than 18 months prior to the
date of the application. If the financial statements are for a period that ended more than six
months prior to the date of submission, interim financial statements (on a monthly or quarterly
basis) must be submitted for a period that ended within the six-month period. We may, at a later
date, require an unqualified opinion in support of any financial statements. The requirement for
financial statements does not apply to wholesale applicants who only operate vending machines
(Form CG-100-V).
Before we can process an application, a federal employer identification number (FEIN or federal
EIN) is required. If the applicant does not currently have an FEIN, they must obtain one from the
Internal Revenue Service.

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