Cigarette Application Screen

Apply for a Cigarette License

This page is designed to help you apply for either a Retail or Wholesale Cigarette Dealer's license.
Please fill in the fields shown below and then click on the Display Completed Application Form button.

* is Required
License Type: *
If this is a renewal, enter last years license number (if known):
Owners Name: *
2nd Owners Name:
Business Name: *
Business Address: *
Business City: *
Business State: *
Business Zip Code: *
Business Sales Tax Vendor's License Nbr:
Business Phone:	enter as 999-999-9999
Business Federal Employer ID Nbr:	enter as 99-99999999
Mailing Address:
Mailing City:
Mailing State:
Mailing Zip Code:
E-mail Address:
Owners Phone:	enter as 999-999-9999
Social Security Nbr:	enter as 999-99-9999
Type of Ownership: *

If this is Wholesale Application* and Corporation Dealer, list officers:*
President
Vice President
Secretary
Treasurer

If you need additional help contact the Auditors Office at 937-225-4314
Location: 451 W. Third St. PO BOX 972 Dayton,OH 45422-1031