Oklahoma Business Registration Packet For Cigarette And Tobacco Licensing - Cigarette And Tobacco Supplement Page 5
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740002
Oklahoma Cigarette and Tobacco Licensing - Supplement
Business Name:
FEIN/SSN:
Store Location:
Current Sales Tax Permit Number:
Section 2
Manufacturer: (continued)
6. Applicant agrees to sell cigarettes and/or tobacco products only to a licensed
wholesaler ................................................................................................................
Yes
No
7. Please check TRUE or FALSE to A or B:
A. “I am a participating manufacturer as defined in Section II(JJ) of the Master
Settlement Agreement as defined in Section 600.22 of Title 37 of the
Oklahoma Statutes” ..........................................................................................
True
False
OR
B. “I am in full compliance with the provisions of Paragraph 2 of Subsection A
of Section 600.23 of Title 37 of the Oklahoma Statutes” ..................................
True
False
8. Are any of the cigarettes you import into the United States in violation
of 19 U.S.C. Section 1681A? ....................................................................................
Yes
No
9. Are any of the cigarettes imported or manufactured not in compliance with the
Federal Cigarette Labeling and Advertising Act, 15 U.S.C., Section 113 et seq.?....
Yes
No
Wholesale Cigarette/Tobacco License:
Section 3
Date of First Sales:
___________ / ___________ / __________
1. Do you owe $500.00 or more in delinquent cigarette or tobacco taxes? ..................
Yes
No
2. Have you had a dealer, wholesaler, retailer license revoked by the Oklahoma Tax
Commission in the past two years? ..........................................................................
Yes
No
3. Have you been convicted of a crime relating to stolen or counterfeit cigarettes,
tobacco products, or receiving stolen or counterfeit cigarettes or tobacco products
or have been convicted of or have entered a plea of guilty or nolo contendere to
any felony? ...............................................................................................................
Yes
No
4. Applicant agrees to the jurisdiction of the Tax Commission and the courts of this
state for the purpose of enforcement of the provisions of Title 68, Sections 301
and 415 et seq. of this title; .......................................................................................
Yes
No
5. Applicant agrees to abide by the provisions of Title 68, Sections 301 and 415
et seq. of this title and the rules promulgated by the Tax Commission with
reference thereto; .....................................................................................................
Yes
No
6. Applicant agrees that it shall not purchase any cigarettes or tobacco products from
or sell to a person or entity required to obtain a license unless such person or
entity has obtained such license; .............................................................................
Yes
No
7. Applicant agrees to sell tobacco products only to a licensed retailer or Indian tribal
entities or licensees of Indian tribal entities. ............................................................
Yes
No
B
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