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Tobacco Retail License (TRL) Application

  1. Is the Tobacco Retail establishment also registered as Deemed Approved with the City (i.e. is this establishment also permitted or conditionally permitted for alcohol sales)?*
  2. The business is eligible for a Combination License, which allows for a discounted license fee and the scheduling of both tobacco and alcohol businesss inspections concurrently. Applicant should proceed to complete this application. Once submitted, a City technician will invoice the applicable fees. Once the fees are paid, the technician will schedule an inspection date. *
  3. Business Information
  4. Business Address

  5. Tobacco Permit License Number

  6. Business Mailing Address

  7. Person to Contact Regarding Inspection Scheduling and Business Compliance
  8. Ownership/Proprietor Information

    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.

  9. Type of Ownership:*
  10. Please convert to PDF before submitting

  11. Owner Mailing Address

  12. Have any of the business owners or any agent of the business owners admitted violating, or have been found to have violated any local, state, or federal law governing the sale of tobacco products?*
  13. Acknowledgement and Signature

    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.

  14. Leave This Blank:

  15. This field is not part of the form submission.