Forms
The following forms are to be used for new applications only. DO NOT use these forms for permit renewals. Please fill out completely and mail completed forms and payment to:
Arkansas Tobacco Control
101 East Capitol Ave., Suite 401
Little Rock, AR 72201-3824
All forms below are in PDF format unless otherwise noted.
| Retail |
|---|
| Retail Cigarette and Tobacco Permit Application and/or Exclusive Vapor Product and Alternative Nicotine Product Permit Application Includes: |
| ATC – R1 2-2020 Retail Application |
| ATC – R9 Replacement Form for Use of Owner’s Permit |
| Tobacco and Vapor Server Awareness Form |
| Special Event Permit |
| New Sales to Minors Sign |
| Cigarette and Tobacco Inventory Instructions |
| Cigarette and Tobacco Inventory Form PDF | EXCEL |
| Required Procedure and Form for Selling Discounted Cigarettes |
| Act 1073 of 2003 – Sale of Brands not on the Attorney General’s Approved-for-Sale Tobacco Products Directory |
| Duplicate Permit Request Form Includes: |
| Duplicate Permit Request Form |
| Wholesale |
|---|
| Wholesale Permit Tobacco Products, Vapor Products, Alternative Nicotine Products, or E-liquid Products Application Includes: |
| Instructions to Obtain a Wholesale Permit |
| Application for Wholesale Permit |
| Affidavit for Wholesale Permit |
| Suggested Advertisement for Wholesale Permit |
| Application for Wholesaler’s Salesperson Permit |
| Wholesale Sales Reporting |
| Act 1073 of 2003 – Sale of Brands not on the Attorney General’s Approved-for-Sale Tobacco Products Directory |
| Vapor Product and E-liquid Product Exclusive Permit (Manufacturer, Wholesaler, and Retailer) |
|---|
| Vapor Product and E-liquid Product Exclusive Permit (Manufacturer, Wholesaler, and Retailer) Application Includes: |
| Vapor Product and E-liquid Product Exclusive Permit Application |
| Affidavit for Vapor Product and E-liquid Product Exclusive Permit Application |
| Wholesale Sales Reporting |
| Tobacco and Vapor Server Awareness Form |
| New Sales to Minors Sign |
| Application for Wholesaler’s Salesperson Permit |
| Application for Manufacturer’s Salesperson Permit |
| Sales Representatives |
|---|
| Wholesaler’s Salesperson Permit Application Includes: |
| Application for Wholesaler’s Salesperson Permit |
| Manufacturer’s Salesperson Permit Application Includes: |
| Application for Manufacturer’s Salesperson Permit |
| Tobacco/Vapor/E-liquid/Alternative Nicotine Products Vendor |
|---|
| Vendor Permit Application Includes: |
| Application for Vendor Permit |
| Vending Machine Stamps Application |
| Vending Machine Operators Bond |
| Application to sell at less than the presumptive cost of doing business |
|---|
| Includes: |
| Application to sell at less than the presumptive cost of doing business |
