Form Ct-Cdl - Application For Distributor License For Cigars And Smoking Tobacco

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Rev. 8/13

Form CT-CDL

Massachusetts

Application for Distributor License

Department of

for Cigars and Smoking Tobacco

Revenue

This application is for a distributor license for cigars and smoking tobacco for the period October 1, 2013 through September 30, 2014. Please read the

instructions below. There is no fee for this license.

Registration Information.

Please print. Note: You must be registered for sales tax before applying.

Legal name of business

Federal Identification number

Application number (DOR use only)

CODE-3

Mailing address

City/Town

State

Zip

Telephone

Trade name

Street address of sale location

City/Town

State

Zip

Telephone

Name(s) of owner(s)

E-mail address

I hereby certify that I agree to conform with the provisions of the Massachusetts General Laws, Chapters 62C and 64C, as amended, and with

all rules and regulations made thereunder, and have complied with all laws of the Commonwealth relating to taxes. Signed under the penalties

of perjury.

Signature

Title

Date

Mail to: Massachusetts Department of Revenue, PO Box 7004, Boston, MA 02204.

General Instructions

You must obtain a distributor license for cigars and smoking to-

Address of sale location. Enter the address of the sale location.

bacco before selling cigars and smoking tobacco as a distributor.

If this address is the same as the mailing address, leave this sec-

You must be registered to collect sales tax before applying

tion blank. Also enter the telephone number for the sale location,

for a license. If you have not registered for sales tax, go to DOR’s

including the area code.

website at or call the Customer Service Bu-

Enter the name(s) of the owner(s) of the business.

reau at (617) 887-MDOR.

Enter the e-mail address, if any, of the business owner.

Effective September 1, 2008, Massachusetts requires that whole -

Signature. Be sure to sign your name above, and enter your

salers who sell tobacco products to retailers in Massachusetts

must collect and prepay the Massachusetts sales tax. The tax to

title and the date on this application. Your application will not be

be collected by wholesalers is 6.25% of the wholesale sales price.

proc essed with out your signature. Mail your application to: Mass -

achu setts Department of Revenue, PO Box 7004, Boston,

Enter all information on application as shown on sample.

MA 02204.

Legal name of business. Enter the legal name of your business

for mailing purposes. For most distributors this will be the same as

Rev. 8/13

Form CT-CDL

their trade name.

Massachusetts

Application for Distributor License

Department of

for Cigars and Smoking Tobacco

Revenue

Federal Identification number. Enter your Federal Identification

This application is for a distributor license for cigars and smoking tobacco for the period October 1, 2013 through September 30, 2014. Please read the

(FID) number. Under Massachusetts law, if you are not a sole

instructions below. There is no fee for this license.

proprietor, you must have a FID number to sell cigars and smok-

Registration Information.

Please print. Note: You must be registered for sales tax before applying.

Legal name of business

Federal Identification number

Application number (DOR use only)

SAMPLE

ing tobacco.

ABC Inc.

987-654-321