Apply for a Retail Cigarette License

This page is designed to help you apply for a Retail Cigarette Dealer's license.
Please fill in the fields shown below and then click on the Display Completed Application Form button.

* is Required
If this is a renewal, enter last year's license number (if known):
Owner's Name: *
2nd Owner's Name:
Business Name: *
Business Address: *
Business City: *
Business State: *
Business Zip Code: *
Business Sales Tax Vendor's License Nbr: Format: (57-999999)
Business Phone: enter as 999-999-9999
Business Federal Employer ID Nbr: enter as 99-99999999
Taxing District:
Mailing Address:
Mailing City:
Mailing State:
Mailing Zip Code:
E-mail Address:
Owner's Phone: enter as 999-999-9999
Social Security Nbr: enter as 999-99-9999
Type of Ownership: *
If you need additional help contact the Auditors Office at 937-225-4314
Location: 451 W. Third St. PO BOX 972 Dayton,OH 45422-1031