Form CG-213 "Cigarette Stamping Agent Certification of Compliance With Tax Law Article 20" - New York

What Is Form CG-213?

This is a legal form that was released by the New York State Department of Taxation and Finance - a government authority operating within New York. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on July 1, 2020;
  • The latest edition provided by the New York State Department of Taxation and Finance;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form CG-213 by clicking the link below or browse more documents and templates provided by the New York State Department of Taxation and Finance.

ADVERTISEMENT
ADVERTISEMENT

Download Form CG-213 "Cigarette Stamping Agent Certification of Compliance With Tax Law Article 20" - New York

708 times
Rate (4.8 / 5) 49 votes
CG-213
Department of Taxation and Finance
Cigarette Stamping Agent Certification of
(7/20)
Compliance with Tax Law Article 20
Transaction and Transfer Tax Bureau FACCTS/Cigarette Tax
This certification covers the period
/
/
through August 31, 2021.
(mm/dd/yy)
Cigarette stamping agent identification
Mark an X in this box if this is an amended certification
(type or print)
Legal name of cigarette stamping agent
Employer identification number (EIN)
Mailing address (number and street or PO box)
City or town
State or province
ZIP code
Telephone number (include area code)
Fax number (include area code)
(
)
(
)
Certification
I certify, in good faith and under penalty of perjury, that none of the unstamped packages of cigarettes the above named cigarette
stamping agent purchases will be resold by the agent in violation of Tax Law Article 20 or in violation of any rule or regulation adopted
pursuant to Article 20.
Specifically, I certify that the agent:
• will not resell unstamped packages of cigarettes in or into New York State, except as specifically authorized by law;
• will not affix stamps to packages of cigarettes unless the agent has received a Form CG-30, Certification of Tobacco Master
Settlement Agreement Status, from the manufacturer of such cigarettes for the current Tobacco Master Settlement Agreement
certification period;
• will not affix stamps to packages of cigarettes that have not been certified or marked as fire safe; and
• will only make tax exempt sales of stamped packages of cigarettes to Indian nations or tribes (other than the Oneida Indian Nation
of New York), or to reservation cigarette sellers, to the extent the agent has received Indian tax exemption coupons or prior approval
from the Tax Department.
I have listed on page 2 of this certification all manufacturers or other persons from whom the agent will purchase or otherwise acquire
unstamped packages of cigarettes and that the agent has provided such manufacturers or other persons with a copy of page 1 of this
certification.
Before the agent purchases unstamped packages of cigarettes from a manufacturer or other person not listed on page 2 of this
certification, the agent will amend this certification with the Tax Department, provide an updated list that includes such manufacturer or
other person to the Tax Department, and provide a copy of page 1 of the amended certification to such manufacturer or other person.
I also certify that this certification applies to each of the agent’s purchases for the entire period covered by the certification. This
certification remains in effect until August 31, 2021. The agent must execute a new certification annually on or before September 1.
Under penalty of perjury, I declare that the statements contained in this certification are true, correct, and complete, and that I am the
of a
, a person authorized to bind the agent making this
(proprietor, general partner, officer, etc.)
(proprietorship, partnership, corporation, etc.)
certification either under the laws of NYS or of the jurisdiction where the agent resides or is organized. This certification is made to
induce tobacco product manufacturers to sell unstamped packages of cigarettes to the above-named agent for the purpose of resale in
or into NYS. I recognize that manufacturers are relying on this certification.
Authorized signature
Title
Printed name
Date
State of New York
}
} SS.:
County of
}
On the
day of
in the year 20
, before me personally appeared
, personally
known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to within
the foregoing instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by
his/her/their signature(s) on the instrument, the individual(s), or the corporation, partnership, LLC upon behalf of which the individual(s)
acted, executed the instrument.
Notary Public
Registration number
If sworn or acknowledged outside of NYS, see Form CG-213-I, Instructions for Form CG-213.
CG-213
Department of Taxation and Finance
Cigarette Stamping Agent Certification of
(7/20)
Compliance with Tax Law Article 20
Transaction and Transfer Tax Bureau FACCTS/Cigarette Tax
This certification covers the period
/
/
through August 31, 2021.
(mm/dd/yy)
Cigarette stamping agent identification
Mark an X in this box if this is an amended certification
(type or print)
Legal name of cigarette stamping agent
Employer identification number (EIN)
Mailing address (number and street or PO box)
City or town
State or province
ZIP code
Telephone number (include area code)
Fax number (include area code)
(
)
(
)
Certification
I certify, in good faith and under penalty of perjury, that none of the unstamped packages of cigarettes the above named cigarette
stamping agent purchases will be resold by the agent in violation of Tax Law Article 20 or in violation of any rule or regulation adopted
pursuant to Article 20.
Specifically, I certify that the agent:
• will not resell unstamped packages of cigarettes in or into New York State, except as specifically authorized by law;
• will not affix stamps to packages of cigarettes unless the agent has received a Form CG-30, Certification of Tobacco Master
Settlement Agreement Status, from the manufacturer of such cigarettes for the current Tobacco Master Settlement Agreement
certification period;
• will not affix stamps to packages of cigarettes that have not been certified or marked as fire safe; and
• will only make tax exempt sales of stamped packages of cigarettes to Indian nations or tribes (other than the Oneida Indian Nation
of New York), or to reservation cigarette sellers, to the extent the agent has received Indian tax exemption coupons or prior approval
from the Tax Department.
I have listed on page 2 of this certification all manufacturers or other persons from whom the agent will purchase or otherwise acquire
unstamped packages of cigarettes and that the agent has provided such manufacturers or other persons with a copy of page 1 of this
certification.
Before the agent purchases unstamped packages of cigarettes from a manufacturer or other person not listed on page 2 of this
certification, the agent will amend this certification with the Tax Department, provide an updated list that includes such manufacturer or
other person to the Tax Department, and provide a copy of page 1 of the amended certification to such manufacturer or other person.
I also certify that this certification applies to each of the agent’s purchases for the entire period covered by the certification. This
certification remains in effect until August 31, 2021. The agent must execute a new certification annually on or before September 1.
Under penalty of perjury, I declare that the statements contained in this certification are true, correct, and complete, and that I am the
of a
, a person authorized to bind the agent making this
(proprietor, general partner, officer, etc.)
(proprietorship, partnership, corporation, etc.)
certification either under the laws of NYS or of the jurisdiction where the agent resides or is organized. This certification is made to
induce tobacco product manufacturers to sell unstamped packages of cigarettes to the above-named agent for the purpose of resale in
or into NYS. I recognize that manufacturers are relying on this certification.
Authorized signature
Title
Printed name
Date
State of New York
}
} SS.:
County of
}
On the
day of
in the year 20
, before me personally appeared
, personally
known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to within
the foregoing instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by
his/her/their signature(s) on the instrument, the individual(s), or the corporation, partnership, LLC upon behalf of which the individual(s)
acted, executed the instrument.
Notary Public
Registration number
If sworn or acknowledged outside of NYS, see Form CG-213-I, Instructions for Form CG-213.
Page 2 of 2 CG-213 (7/20)
A
B
Name and address of manufacturer or other person from whom the agent
Manufacturer’s EIN
will purchase or otherwise acquire unstamped packages of cigarettes
Any agent who purchases unstamped packages of cigarettes from any person, including, but not limited to, a tobacco product
manufacturer, must complete this certification prior to such purchase, if it is intended for resale in or into New York State (NYS). The
agent must provide that person and the Tax Department with this certification indicating that the purchased cigarettes will not be resold
in violation of Tax Law Article 20.
File both pages (1 and 2) of the certification with the Tax Department. Provide page 1 to each manufacturer or other person from whom
you will purchase unstamped packages of cigarettes.
Page of 2