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1
 Enter Your Information
 
2
 Review Your Information
 
3
 Print Your Confirmation








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Our Online Order Forms are Secure and Safe. We had made our Online process as simple as possible. Simply fill in your Information, Review, submit and Print the confirmation page for your record.
You can complete online application in just 3 easy steps that will take about 5-10 minutes to complete.

RETAIL CIGARETTE LICENSE
Please complete the requested information below for your Retail Cigarette License. Infotax Square representative will begin processing your order upon receipt of payment.

Exempt States for Cigarette License: Arizona, Colorado, Illinois, Kentucky, New Mexico and Virginia
 
PLEASE SELECT
Type of Entity:
Select State:
CONTACT INFORMATION (Business Location Information)
First Name:
Last Name:
Address:
Suite/Apt:
City:
State:
Zip:
Phone:
Fax:
 
BUSINESS OVERVIEW
Name of Entity:
State of Formation:
Date of Formation: (mm/dd/yyyy)
Estimated Monthly Gross Receipts/Sales:
Employer ID Number:
Copy Address from Contact Information if same
Address:
Suite/Apt:
City:
State:
Zip:
Date Business Planning to Start: (mm/dd/yyyy)
Application Type: New Application
Registering Additional Locations or Vending Machines
Please Select All that applies how the cigarettes or tobacco products are sold at retail: Retail Location (example: convinient store)
Cars, Trucks, Stands etc.
Vending Machines
Business Description:
 
BANK INFORMATION (if any)
To apply for Sales Tax ID Number, Bank information is required by the department of revenue where all the sales receipts will be deposited.
Bank Name:
Account Number:
Address:
Suite/Apt:
City:
State:
Zip:
 
OFFICERS/MEMBERS INFORMATION
OFFICER 1
Full Name:
Title:
(President, Vice President, Secratary, Treasurer, Owner, Member)
Driving License Number: (if any)
Social Security Number: (999-99-9999)
Percentage of Ownership:
Date of Birth: (mm/dd/yyyy)
Residence Address:
City, State, Zip:
Phone, Fax:
OFFICER 2
Full Name:
Title:
(President, Vice President, Secratary, Treasurer, Owner, Member)
Driving License Number: (if any)
Social Security Number: (999-99-9999)
Percentage of Ownership:
Date of Birth: (mm/dd/yyyy)
Residence Address:
City, State, Zip:
Phone, Fax:
OFFICER 3
Full Name:
Title:
(President, Vice President, Secratary, Treasurer, Owner, Member)
Driving License Number: (if any)
Social Security Number: (999-99-9999)
Percentage of Ownership:
Date of Birth: (mm/dd/yyyy)
Residence Address:
City, State, Zip:
Phone, Fax:
 
ORDER INFORMATION
Do you have Sales Tax ID Number? Yes No
If you are selling products or offering services that is taxable you must apply for sales tax id number in your state. The process of getting a Sales Tax ID is called obtaining a "Certificate of Authority", "Sales tax ID Number".
Description Cost of Each No. of Locations Total
Standard State Filing Fee $ $
Vending Machines $ $
Infotax Square Fee: $
Shipping and Handling: $
Grand Total: $
 
LOGIN INFORMATION
Please Fill up the Information Required for your future Login and check the order status. If you already have the login information for Infotax then please type your existing email and password.
Email:
Password:
 
CARDHOLDER INFORMATION
First Name:
Last Name:
Billing Address:
City:
State:
Zip:
Phone:
Fax:
Card Type:
Expiration Date:
Card Number:
Country:
 
General Comments / Instructions:
 
TERMS OF USE AGREEMENT & DISCLAIMER


Yes, I have read and accept the above terms and condition. (Please Select before submitting the form)
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