Cayuga County, NY · Cayuga County
Application for a Tobacco Retail License
Cayuga County tobacco retailers use this application to request a license by providing business, facility, owner, and certification information.
At a glance
- Issued by
- City of Cayuga County · Cayuga County, Cayuga County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- cayugacounty.us
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This application is for a business seeking a Cayuga County tobacco retail license. It asks for the retail business and responsible party’s contact information, facility type, details about a current Department of Taxation & Finance Retail Dealer Certificate, and answers about past license revocation and outstanding county charges. The responsible party or owner signs and dates the certification.
Who needs it
A responsible party or owner seeking a tobacco retail license for a business operating in Cayuga County needs to complete this application.
How to submit it
The form names the Cayuga County Health Department and lists its address as 8 Dill Street, Auburn, NY 13021. It does not state how to submit the application, so check the county website for current contact details.
About notarization
This application is signed and dated without a notary; it does not identify any notarized attachment or sworn related step.
How to submit this form
- 1
Download the Application
Download the tobacco retail license application PDF.
- 2
Complete the Application
Fill in the business, responsible party, and facility information, and answer the questions in the application.
- 3
Review Certificate Details
Gather the details requested about the business’s Department of Taxation & Finance Retail Dealer Certificate, if applicable.
- 4
Sign and Date
The responsible party or owner should sign, print their name, provide their title, and date the application.
- 5
Contact the County Department
The form names the Cayuga County Health Department; check the county website for current submission details.
Frequently asked questions
- Who should complete the tobacco retail license application?
- The responsible party or owner of a tobacco retail business should complete the application, providing business, facility, and contact information.
- What information does the application request?
- It asks for business and owner details, facility type, information about a current Retail Dealer Certificate, and answers about license revocation and outstanding county charges.
- Do I need a notary for the tobacco retail license application?
- No. The application is signed and dated without a notary, and it does not identify a notarized attachment or sworn related step.
- How do I submit the tobacco retail license application?
- The form names the Cayuga County Health Department at 8 Dill Street, Auburn, NY 13021, but does not state a submission method. Check the county website for current contact details.