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The Official Website of the State of Arkansas

Applications and Forms

Applications and Forms

The following forms are to be used for new applications only. DO NOT use these forms for permit renewals. Please fill out completely and mail completed forms and payment to:

Arkansas Tobacco Control
101 East Capitol Ave., Suite 401
Little Rock, AR 72201-3824

All forms below are in PDF format unless otherwise noted.

Manufacturer
Manufacturer Tobacco Products, Vapor Products, Alternative Nicotine Products, or E-liquid Products Only Permit Application Includes:
Manufacturer Tobacco Products, Vapor Products, Alternative Nicotine Products, or E-liquid Products Only Permit Application
Application for Manufacturer’s Salesperson Permit
Manufacturer’s Application for Fire Safe Standard Compliant Cigarette Approval Includes using either one of these sets of forms:
Manufacturer’s Application for Fire Safe Standard Compliant Cigarette Approval (PDF)
Manufacturer’s Application for Fire Safe Standard Compliant Cigarette Approval (Excel)
Manufacturer Directory for Vapor Products and E-liquid Products Forms:
Manufacturer Directory for Vapor Products and E-liquid Products Certification Form
Material Change to Certification Form for Manufacturer Directory for Vapor Products and E-liquid Products
Change of Agent Form for Manufacturer Directory for Vapor Products and E-liquid Products
Importer Appointment of Agent Form for Manufacturer Directory for Vapor Products and E-liquid Products
Retail
Retail Cigarette and Tobacco Permit Application and/or Exclusive Vapor Product and Alternative Nicotine Product Permit Application Includes:
Retail Application – Retail Permit All Inclusive Tobacco Application
Retail Application – Vapor Product and E-Liquid Product Only
Replacement Form for Use of Owner’s Permit
Tobacco and Vapor Server Awareness Form
Temporary Event/Special Event Permit Application
New Sales to Minors Sign
Inventory Form (PDF)
Inventory Form (Excel)
Required Procedure and Form for Selling Discounted Cigarettes
Act 1073 of 2003 – Sale of Brands not on the Attorney General’s Approved-for-Sale Tobacco Products Directory
Wholesale
Wholesale Permit Tobacco Products, Vapor Products, Alternative Nicotine Products, or E-liquid Products Application Includes:
Application for Wholesale Permit
Application for Wholesaler’s Salesperson Permit
Wholesale Sales Reporting
Act 1073 of 2003 – Sale of Brands not on the Attorney General’s Approved-for-Sale Tobacco Products Directory
ATC Insufficient Fund Notice
Sales Representatives
Wholesaler’s Salesperson Permit Application Includes:
Application for Wholesaler’s Salesperson Permit
Manufacturer’s Salesperson Permit Application Includes:
Application for Manufacturer’s Salesperson Permit
Tobacco/Vapor/E-liquid/Alternative Nicotine Products Vendor
Vendor Permit Application Includes:
Application for Vending Permit
Vending Machine Stamps Application
Vending Machine Operators Bond
Additional Forms
Report a Violation
Request a Training
Instructions for Selling a Retail Store or Cancelling a Permit
Permit Cancellation Form
Instructions and Form for Selling Discounted Cigarettes
Product Transfer Form
How to Identify Vapor Products and E-liquid Products that Must Appear on the
Directory
Application to sell cigarettes at less than the presumptive cost of doing business
Duplicate Permit Request Form
Consumable Hemp Forms
What is Consumable Hemp Chart
Consumable Hemp Products Wholesale Permit Application
Consumable Hemp Products Manufacturer Permit Application
Consumable Hemp Products Retail Permit Application
Consumable Hemp Pregnancy Warning Sign
Consumable Hemp Server Awareness Form
Consumable Hemp No Sales To Minor Sign
Consumable Hemp Product Inventory Form
Consumable Hemp Product Transfer Form
Consumable Hemp Product Directory Certification Form
Consumable Hemp Replacement Notice