Ets Form 007 - Cigarette Wholesalers & Other Tobacco Wholesalers, Cigarette Importer, Cigarette Manufacturer License Application
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Wyoming Department of Revenue
Excise Tax Division
122 W. 25th Street, Herschler Bldg.
Department Use Only
Cheyenne, Wyoming 82002-0110
RID:__________________
License:________________
Freq:__________________
Cigarette Wholesalers & Other Tobacco Wholesalers, Cigarette
Importer, Cigarette Manufacturer License Application
Date Business began Wholesaling Cigarettes & or Other Tobacco Products in Wyoming:
Ownership Name
Type of Ownership: Individual
Partnership
Corporation
Association or Other
(specify)
Business Name or DBA:
Business Location: _________________________________________________________________________
Street Address
City
State
Zip
Mailing Address:
Street Address
City
State
Zip
Business Phone Number: (
)
-
Fax Number: (
)
-
1. Will you be purchasing unstamped cigarettes directly from a manufacturer for sale or resale in
Wyoming? Yes
No
2. Are you a cigarette importer who imports into the United States either directly or indirectly a finished
cigarette for sale or distribution in Wyoming? Yes
No
3. Are you a cigarette manufacturer who manufactures, fabricates, assembles, processes or labels a
finished cigarette for sale in Wyoming? Yes
No
4. Are you an Other Tobacco Products Manufacturer who manufactures, fabricates, assembles,
processes, or labels Other Tobacco Products for sale in Wyoming? Yes
No
5. Will you be purchasing cigars, snuff, or other tobacco products directly from a manufacturer for sale
or resale in Wyoming? Yes
No
6. Do you sell at retail stamped cigarettes or other tobacco products directly to Wyoming consumers?
Yes
No
If yes, indicate your Wyoming Sales/Use Tax License Number ___________________
You must acquire a separate license for each business location. The application shall be signed by: The
Owner, if the business is a sole proprietorship. All partners, if the business is a partnership. Member or
manager if a LLC. One major office if a corporation.
Signature:_______________________________________________Title:_____________________________
Signature:_______________________________________________Title:_____________________________
An application and license is required for each business location. A Ten dollar ($10.00) License Fee must accompany each
application. Remittance to be made payable to: Department of Revenue
ETS Form 007 (revised 4/25/11)
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