Form Cg-100-C - Checklist For Applications Cg-100-A, Cg-100-W, And Cg-100-V Page 3
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3CG-100-C (2/12) Page 3 of 3
You will be required to provide the following when enrolling on the Web site:
ORI number - NY0017200
Fingerprint reason - Licensing
At the fingerprint location, they will give you two receipts indicating your name, fingerprint site location,
date and time, fee paid, and reason for fingerprinting.
NOTE: You must submit one receipt with your application for licensing.
* For purposes of this application, the term controlling person means any person who is an officer,
director, or partner (or, in the case of a limited liability company, an officer, member, or a person
having, with respect to the limited liability company, authority analogous to that of a corporate
officer or director) of an applicant for an agent or wholesale dealer license under Article 20 of the
Tax Law; or, if the applicant is a corporation, a shareholder who directly or indirectly owns more
than 10% of the number of shares of voting stock of the corporation. It also includes persons who
do or will exercise authority within the business comparable to the authority normally exercised by
corporate officers, regardless of the form of business organization or lack of actual title.
Include all additional sheets necessary for the completion of items on each form submitted.
Reference the item number and form number on all additional sheets.
For more information, see specific form instructions, the Tax Law, or tax regulations.
Need help?
Visit our Web site at
• get information and manage your taxes online
• check for new online services and features
Telephone assistance
Sales Tax Information Center:
(518) 485-2889
To order forms and publications:
(518) 457-5431
Text Telephone (TTY) Hotline (for persons with
hearing and speech disabilities using a TTY):
(518) 485-5082
Persons with disabilities: In compliance with the
Americans with Disabilities Act, we will ensure that our
lobbies, offices, meeting rooms, and other facilities are
accessible to persons with disabilities. If you have questions
about special accommodations for persons with disabilities, call the
information center.
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