Berryville, VA · Clarke County
Cigarette Tax Registered Agent Application
Businesses use this application to register with the Town of Berryville to purchase or affix town cigarette tax stamps or stamped cigarettes.
What this form is
The application is for registration required by the Town of Berryville Cigarette Tax Ordinance for dealers purchasing or affixing town cigarette stamps or stamped cigarettes. It requests business and ownership details, responsible contacts, document storage information, and supplier or stamping equipment details, as applicable. The applicant also agrees to reporting, tax, inspection, and record-retention requirements stated on the form.
Who needs it
A dealer applying to register with the Town of Berryville to purchase or affix town cigarette stamps or stamped cigarettes needs this application.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed without a notary; its affidavit is a declaration under penalties of perjury, and the listed applicant signs and dates it.
How to submit this form
- 1
Download The Application
Download the Cigarette Tax Registered Agent Application PDF.
- 2
Complete The Application
Enter the business, ownership, contact, records, and cigarette supplier or stamping equipment information that applies.
- 3
Gather Any Attachments
Attach a sheet with additional partners or corporate officers if needed.
- 4
Sign And Submit
Have an individual, partner, or listed corporate officer sign and date the application, then submit it to the city department named on the form.
Frequently asked questions
- What is the Cigarette Tax Registered Agent Application for?
- It is used to apply for registration required by the Town of Berryville to purchase or affix town cigarette tax stamps or stamped cigarettes.
- Who completes this application?
- A dealer applying for registration completes the business and ownership information. An individual, partner, or corporate officer listed on the form must sign.
- Do I need a notary for the Cigarette Tax Registered Agent Application?
- No. The document is signed without a notary; it includes an affidavit declaring the contents true under penalties of perjury, which the listed applicant signs and dates.
- How do I submit the Cigarette Tax Registered Agent Application?
- Submit it to the city department named on the form; check the city website for current contact details.