Looking for a New York City Department Of Finance Forms And Templates? Download it for free!

Form Ctx-A.34a - Report Of Changes In Personnel, Motor Vehicles, And Location Of Vending Machines

NYC DEPARTMENT OF FINANCE

ENFORCEMENT DIVISION

REPORT OF CHANGES IN PERSONNEL, MOTOR

VEHICLES, AND LOCATION OF VENDING MACHINES

Finance

NYC Department of Finance, Enforcement Division, CTX Unit, 30-10 Starr Avenue, 2nd Floor, Long Island City, NY 11101

Instructions: This form is used by all agent-jobbers, sub-jobbers and vending machine operators to report all changes in per-

sonnel (sales personnel, service personnel, etc.), motor vehicles, and locations of vending machines as required by the whole-

sale cigarette dealerʼs license issued to you by the City of New York. Under DELETIONS, list information from schedules you

submitted previously that should be removed. Under ADDITIONS, list information that should be added to the most recently

submitted schedule.

Date:

______________________

NYC License #:______________________________

Licensee Name: ____________________________________________________________________________________________

Address:__________________________________________________________________________________________________

Number and Street

City:_______________________________________________________________ State: ________ Zip Code: ______________

DELETIONS

ADDITIONS

Name of Officer/Partner: __________________________________________ Title: ____________________________

Signature:________________________________________________________________________________________

Visit Finance at nyc.gov/finance

CTX-A.34a 07.11.11

Form Ctx-A.34a - Report Of Changes In Personnel, Motor Vehicles, And Location Of Vending Machines