"Tobacco Retailer's License Annual Application" - City of Rancho Mirage, California

Tobacco Retailer's License Annual Application is a legal document that was released by the Administrative Services Department - City of Rancho Mirage, California - a government authority operating within California. The form may be used strictly within City of Rancho Mirage.

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ANNUAL APPLICATION
TOBACCO RETAILER’S LICENSE
A Tobacco Retailer’s License is required pursuant to City of Rancho Mirage Ordinance
725, Chapter 5.24 of the Rancho Mirage Municipal Code. A separate application shall be
submitted for each tobacco retailer’s location.
Applicant Name: ___________________________________________________
Applicant Address: _________________________________________________
Applicant Phone: ___________________________________________________
Business Name: ____________________________________________________
Business Address: __________________________________________________
Business Phone: ____________________________________________________
Indicate type of business (i.e. drug or grocery store, gasoline station, etc.):
_________________________________________________________________
Describe the area within your business establishment to be used for cigarette sales
(for example, cigarettes sold by cashier at check out stand, customers help
themselves at cigarette display):________________________________________
__________________________________________________________________
________________________________________
_______________
Signature
Date
The Application Fee of $5.00 is due annually. Please make check payable to
“City of Rancho Mirage” and enclose with this application.
Please contact the City of Rancho Mirage’s Finance Division if you need further
assistance.
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ANNUAL APPLICATION
TOBACCO RETAILER’S LICENSE
A Tobacco Retailer’s License is required pursuant to City of Rancho Mirage Ordinance
725, Chapter 5.24 of the Rancho Mirage Municipal Code. A separate application shall be
submitted for each tobacco retailer’s location.
Applicant Name: ___________________________________________________
Applicant Address: _________________________________________________
Applicant Phone: ___________________________________________________
Business Name: ____________________________________________________
Business Address: __________________________________________________
Business Phone: ____________________________________________________
Indicate type of business (i.e. drug or grocery store, gasoline station, etc.):
_________________________________________________________________
Describe the area within your business establishment to be used for cigarette sales
(for example, cigarettes sold by cashier at check out stand, customers help
themselves at cigarette display):________________________________________
__________________________________________________________________
________________________________________
_______________
Signature
Date
The Application Fee of $5.00 is due annually. Please make check payable to
“City of Rancho Mirage” and enclose with this application.
Please contact the City of Rancho Mirage’s Finance Division if you need further
assistance.
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