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KENNY C. GUINN Governor CHARLES E. CHINNOCK Executive Director BARBARA SMITH CAMPBELL Chair, Nevada Tax Commission STATE OF NEVADA DEPARTMENT OF TAXATION Web Site: http://tax.state.nv.us 1550 E. College Parkway, Suite 115 Carson City, Nevada 89706-7937 Phone: (775) 684-2000 Fax: (775) 684-2020 In State Toll Free (800) 992-0900 LAS VEGAS OFFICE Grant Sawyer Office Building, Suite 1300 555 E. Washington Avenue Las Vegas, Nevada, 89101 Phone: (702) 486-2300 Fax: (702) 486-2373 RENO OFFICE 4600 Kietzke Lane Building L, Suite 235 Reno, Nevada 89502 Phone: (775) 688-1295 Fax: (775) 688-1303 HENDERSON OFFICE 2550 Paseo Verde Parkway Suite 180 Henderson, Nevada 89074 Phone:(702) 486-2300 Fax: (702) 486-3377 SIGNATURE AUTHORIZATION FOR CIGARETTE STAMPS Cigarette Wholesale Dealer: __________________________________________________________________ License Number: ___________________________________________________________________________ The person(s) listed below are authorized to purchase and take receipt of Nevada cigarette tax stamps on behalf of ___________________________________________________________________________________________ ___________________________________________________________________________________________ This Authorization is effective as of ___________________________ and will continue in force until revised by the cigarette wholesale dealer or revoked/canceled by the Department of Taxation. ______________________________________________ __________________________________________ Signature and title of person authorized to act on behalf Type or print Of the above stated cigarette wholesale dealer Name (Type or Print) Signature 1. ___________________________________________ _________________________________________ 2. ___________________________________________ _________________________________________ 3. ___________________________________________ _________________________________________ 4. ___________________________________________ _________________________________________ 5. ___________________________________________ _________________________________________ 6. ___________________________________________ _________________________________________ 7. ___________________________________________ _________________________________________ 8. ___________________________________________ _________________________________________ 9. ___________________________________________ _________________________________________ 10. ___________________________________________ _________________________________________

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tax.state.nv.us documents Sig Auth Cig Stamps

  • 1. KENNY C. GUINN Governor CHARLES E. CHINNOCK Executive Director BARBARA SMITH CAMPBELL Chair, Nevada Tax Commission STATE OF NEVADA DEPARTMENT OF TAXATION Web Site: http://tax.state.nv.us 1550 E. College Parkway, Suite 115 Carson City, Nevada 89706-7937 Phone: (775) 684-2000 Fax: (775) 684-2020 In State Toll Free (800) 992-0900 LAS VEGAS OFFICE Grant Sawyer Office Building, Suite 1300 555 E. Washington Avenue Las Vegas, Nevada, 89101 Phone: (702) 486-2300 Fax: (702) 486-2373 RENO OFFICE 4600 Kietzke Lane Building L, Suite 235 Reno, Nevada 89502 Phone: (775) 688-1295 Fax: (775) 688-1303 HENDERSON OFFICE 2550 Paseo Verde Parkway Suite 180 Henderson, Nevada 89074 Phone:(702) 486-2300 Fax: (702) 486-3377 SIGNATURE AUTHORIZATION FOR CIGARETTE STAMPS Cigarette Wholesale Dealer: __________________________________________________________________ License Number: ___________________________________________________________________________ The person(s) listed below are authorized to purchase and take receipt of Nevada cigarette tax stamps on behalf of ___________________________________________________________________________________________ ___________________________________________________________________________________________ This Authorization is effective as of ___________________________ and will continue in force until revised by the cigarette wholesale dealer or revoked/canceled by the Department of Taxation. ______________________________________________ __________________________________________ Signature and title of person authorized to act on behalf Type or print Of the above stated cigarette wholesale dealer Name (Type or Print) Signature 1. ___________________________________________ _________________________________________ 2. ___________________________________________ _________________________________________ 3. ___________________________________________ _________________________________________ 4. ___________________________________________ _________________________________________ 5. ___________________________________________ _________________________________________ 6. ___________________________________________ _________________________________________ 7. ___________________________________________ _________________________________________ 8. ___________________________________________ _________________________________________ 9. ___________________________________________ _________________________________________ 10. ___________________________________________ _________________________________________