Form AG-SOC "Request for Tobacco Statement of Condition" - Ohio

What Is Form AG-SOC?

This is a legal form that was released by the Ohio Department of Taxation - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2018;
  • The latest edition provided by the Ohio Department of Taxation;
  • 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 fillable version of Form AG-SOC by clicking the link below or browse more documents and templates provided by the Ohio Department of Taxation.

ADVERTISEMENT
ADVERTISEMENT

Download Form AG-SOC "Request for Tobacco Statement of Condition" - Ohio

Download PDF

Fill PDF online

Rate (4.3 / 5) 71 votes
Ohi
.
1
Q
··
_
Department of
,
. _.
Tax.ation
AG-SOC
Reset Form
Rev. 3/18
Tax Release Unit
P.O. Box 182382
Columbus, OH 43218-2382
REQUEST FOR TOBACCO STATEMENT OF CONDITION
General Information
This form should only be used to request a Statement of Condition pursuant to an Attorney General’s Tobacco Certificate of Compliance.
Allow 2 weeks for processing of this form.
Send your completed form (and TBOR1 Form if applicable) to the mail, fax or email listed above.
Step 1: Identify your business
Legal Name
Ohio State Charter Number (if applicable)
Doing business as (DBA) Street address
Ohio Sales Tax Account Number (if applicable)
Street address
Ohio Withholding Tax Account Number (if applicable)
City, State, ZIP
OTP Tobacco Account (if applicable)
Telephone Number
Tobacco MFG. Account (if applicable)
Federal Employer Identification Number (FEIN)
Cigarette License number (if applicable)
Step 2: Identify the Requestor
Disclosure Authorization: If requestor is a
Name
Third Party Taxpayer Representative, you must
include a completed form TBOR1. If TBOR1
Title
does not accompany this form, your request will
Street address
not be processed.
City, State, ZIP
Step 3: Sign below
I declare under penalty of perjury that I am an owner, officer, or other authorized agent for the business seeking this statement
of condition. [If you have been appointed as representative for the taxpayer, you must attach a copy of your Declaration of
Tax Representative (Form TBOR-1).] I expressly waive the confidentiality provisions of the Ohio Revised Code, which would
otherwise prohibit disclosure, and authorize the Department of Taxation to provide a copy of the Statement of Condition to the
Ohio Attorney General.
Signature
Date
Title
Print or type name
Ohio Department of Taxation
Telephone: 1-855-995-4422
Tax Release Unit
Fax: (206) 984-0378
P.O. Box 182382
Email: Taxreleasegroup@tax.state.oh.us
Columbus, OH 43218-2382
Ohi
.
1
Q
··
_
Department of
,
. _.
Tax.ation
AG-SOC
Reset Form
Rev. 3/18
Tax Release Unit
P.O. Box 182382
Columbus, OH 43218-2382
REQUEST FOR TOBACCO STATEMENT OF CONDITION
General Information
This form should only be used to request a Statement of Condition pursuant to an Attorney General’s Tobacco Certificate of Compliance.
Allow 2 weeks for processing of this form.
Send your completed form (and TBOR1 Form if applicable) to the mail, fax or email listed above.
Step 1: Identify your business
Legal Name
Ohio State Charter Number (if applicable)
Doing business as (DBA) Street address
Ohio Sales Tax Account Number (if applicable)
Street address
Ohio Withholding Tax Account Number (if applicable)
City, State, ZIP
OTP Tobacco Account (if applicable)
Telephone Number
Tobacco MFG. Account (if applicable)
Federal Employer Identification Number (FEIN)
Cigarette License number (if applicable)
Step 2: Identify the Requestor
Disclosure Authorization: If requestor is a
Name
Third Party Taxpayer Representative, you must
include a completed form TBOR1. If TBOR1
Title
does not accompany this form, your request will
Street address
not be processed.
City, State, ZIP
Step 3: Sign below
I declare under penalty of perjury that I am an owner, officer, or other authorized agent for the business seeking this statement
of condition. [If you have been appointed as representative for the taxpayer, you must attach a copy of your Declaration of
Tax Representative (Form TBOR-1).] I expressly waive the confidentiality provisions of the Ohio Revised Code, which would
otherwise prohibit disclosure, and authorize the Department of Taxation to provide a copy of the Statement of Condition to the
Ohio Attorney General.
Signature
Date
Title
Print or type name
Ohio Department of Taxation
Telephone: 1-855-995-4422
Tax Release Unit
Fax: (206) 984-0378
P.O. Box 182382
Email: Taxreleasegroup@tax.state.oh.us
Columbus, OH 43218-2382