Tobacco Permit License Number
Business Mailing Address
Definition of Proprietor: A person with an ownership or interest in a business. An ownership interest shall be deemed to exist when a person has a 10% or greater interest in the stock, assets, or income of a business other than the sole interest of security for debt.
Please convert to PDF before submitting
Owner Mailing Address
I declare under penalty of perjury, under the laws of the State of California, that this application is true and correct to the best of my knowledge. I certify that I will sell tobacco products in accordance with all applicable federal, state, and local laws and regulations. I further understand that any false statements made in this application are grounds for denial or revocation of the Tobacco Retail License. I authorize the City to seek verification of the information contained in the application.
This field is not part of the form submission.
* indicates a required field