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State of Arizona
Department of Revenue

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Tobacco Forms

Form NumberForm NameGet FormGet InstructionsPosted
11134PACT Act StatementDownload Form  
811Revenue Stamp TransactionDownload Form 10/6/2016
840Cigarette Distributor's Claim for Refund of Cigarette Taxes PaidDownload Form 9/18/2014
840-CAffidavit for Refund of Taxes Paid for the Returns by a Distributor of Other Tobacco ProductsDownload Form 9/18/2014
841Cigarette Distributor's Report of Cigarettes Received in Packages Other Than 20s or 25sDownload Form  
845-CIGRetailer’s Report of Cigarettes Sold Download Form  
845-OTPRetailer’s Report of Other Tobacco Products SoldDownload Form  
850Distributor Request to Submit Alternative Proof to Establish Entitlement to Rebate of Tobacco TaxDownload Form 12/17/2015

NOTE:  Applications for a tobacco distributor license can be submitted electronically through Arizona Luxury Tax Online (“ALTO”) at https://luxury.aztaxes.gov. If an application form is needed, please contact the Tobacco Tax Unit at (602) 716-7808.