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.
| Manufacturer |
|---|
| Manufacturer Cigarette Only Permit Application Includes: |
| Application for Manufacturer Cigarette Only Permit |
| Application for Manufacturer’s Salesperson Permit |
| Manufacturer Tobacco Products and Alternative Nicotine Products Only Permit Application Includes: |
| Application for Manufacturer Tobacco Products and Alternative Nicotine Products Only Permit |
| Application for Manufacturer’s Salesperson Permit |
| Manufacturer Vapor Product and E-liquid Product Only Permit Application Includes: |
| Application For Manufacturer Vapor Product and E-liquid Product Only Permit |
| Application for Manufacturer’s Salesperson Permit |
| Manufacturer’s Application for Fire Safe Standard Compliant Cigarette Approval Includes using either one of these sets of forms: |
| Manufacturer’s Application for Fire Safe Standard Compliant Cigarette Approval | PDF | EXCEL |
| Retail |
|---|
| Retail Cigarette and Tobacco Permit Application and/or Exclusive Vapor Product and Alternative Nicotine Product Permit Application Includes: |
| Retail Application – All Inclusive |
| Retail Application – Vapor Product and E-Liquid Product Only |
| ATC – R9 Replacement Form for Use of Owner’s Permit |
| Tobacco and Vapor Server Awareness Form |
| Temporary Event/Special Event Permit Application |
| 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: |
| Application 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 |
| ATC Insufficient Fund Notice. PDF |
| 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 |
| 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 Vending 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 |
