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Matrix Insurance Agency, Inc (New York)
 

Retail Cigarette License





May Not Be Required To Register Cigarette License in the following States.
For Additional Information Click the link below:

Arizona, Colorado, Idaho,New Mexico, Oregon, South Carolina, South Dakota and Tennessee .

If additional County or States fees are required our representative will contact you for additional payment.
 
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*:
PLEASE SELECT SUBSCRIPTION TYPE
Subscription Type: New Subscription
Re-new Existing Subscription
PLEASE SELECT
Select State*:
Select County: *:
Type of Entity*:
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".
Do you want to apply for Sales Tax ID Number? Yes No
Sales Tax Vendor ID:
Standard State Filing Fee / Retail Location: $
No. of Retail Locations*:
Do You Want To Apply For Vending Machine?*:
Yes No
Fee / Vending Machine: $
No. of Vending Machines* :
Infotax Square and State Fees for Sales Tax ID : $
Infotax Square Fee : $
Shipping and Handling : $
Notification:$
Total: $
Reseller Discount: $
Total: $
CONTACT INFORMATION (This is where we will ship your documents)
First Name*:
Last Name*:
Address*:
Suite/Apt:
City*:
State*:
Zip*:  (99999) OR (99999-9999)
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*:  (99999) OR (99999-9999)
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:  (99999) OR (99999-9999)
 
OFFICERS/MEMBERS INFORMATION
OFFICER 1
Copy from Contact Information if same
Full Name*:
Title*:
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*:  (99999) OR (99999-9999)
Phone:
Fax:
OFFICER 2 
Full Name:
Title:
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:  (99999) OR (99999-9999)
Phone:
Fax:
OFFICER 3 
Full Name:
Title:
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:  (99999) OR (99999-9999)
Phone:
Fax:
PAYMENT INFORMATION
  Same as Contact Information
First Name*:
Last Name*:
Billing Address*:
City*:
State*:
Zip*:  (99999) OR (99999-9999)
Phone*:
Fax:
Card Type*:
Expiration Date*:
Card Number*:
Card Security Code*:
Please use the security code as follow:

1. Master Card- Please insert 3 digits security code from the back of the card
2. Visa Card- Please insert 3 digits security code from the back of the card
3. Discover Card- Please insert 3 digits security code from the back of the card
4. American Express- Please insert 4 digits security code from the front of American Express

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