Tobacco Retail License – Santa Ana, CA

The Application for Tobacco Retail License is the City of Santa Ana form used to request, renew, re-issue, transfer or end a permit to retail tobacco products at a fixed business address in Santa Ana, issued under City of Santa Ana Ordinance No. 2729.

The form states that a Tobacco Retail License from the City is required before retailing any tobacco, tobacco products or paraphernalia, and that the license depends on observing all federal, state and local tobacco laws. Selling tobacco without a license is described as a serious offense that can bring substantial penalties, including fines and denial of future City of Santa Ana Tobacco Retailing Permits.

The application collects the business name, phone, business address and mailing address, the business's California Department of Tax and Fee Administration cigarette retail license number, and the name, main phone, driver's license and email of up to two owner/operators. It also carries two written statements about nitrous oxide (SAMC section 18-93(f)(6)) and gambling (SAMC section 10-55), and a statement that the information given is true and correct.

Permits are issued to fixed addresses only, and each address needs its own permit. A permit lasts one year, from April 1 to March 31 of the following year. The City's Finance Department is listed as the issuing agency, and the form has a block marked For Office Use Only that the applicant leaves blank.

Any business that retails tobacco, tobacco products or paraphernalia in the City of Santa Ana needs a Tobacco Retail License, and the owner or operator completes this application for it. The form offers these purposes, and you mark the one that applies:

• New Permit for a business that does not yet hold one;
• Re-Issuing a Revoked Permit;
• Annual Renewal of an existing permit;
• Change of Ownership;
• E-Cigarettes ONLY, for a business that sells e-cigarettes only;
• Discontinue sale of tobacco products, for which the form asks you to complete the application and sign it.

Because permits are issued to fixed addresses only, a business with more than one location completes a separate application and holds a separate permit for each address. The form has room for two owner/operators. The signature line is for the owner(s); the form describes no other signer or representative.

An applicant must be able to make the two written statements on the form: that they do not intend to have, permit or sell nitrous oxide at the establishment, and that they do not intend to permit gambling there.

File the application before you begin retailing tobacco, tobacco products or paraphernalia in Santa Ana, because the City requires the license first. Each permit runs for one year, beginning April 1 and ending March 31 of the following year, so an existing permit is renewed with the Annual Renewal option for the next term.

Use the other options when the situation changes: Change of Ownership when the business changes hands, Re-Issuing a Revoked Permit after a revocation, and Discontinue sale of tobacco products when you stop selling.

The form prints no separate submission deadline beyond the permit term. It does warn that a reinstatement fee will be due for late payments, so send payment with the application.

The form gives one channel: mail. Send the completed and signed application, together with payment, to:

Tobacco Retail License (M-96) P.O. Box 1981 Santa Ana, CA 92702

• Payment: an annual tobacco permit fee applies, and the form asks you to submit payment to CITY OF SANTA ANA - TOBACCO ORDINANCE with your application. The fee amount is printed on the form; a reinstatement fee applies to late payments.
• Signature: the owner(s) must sign and date the form before it is mailed.
• Office block: leave the For Office Use Only section (permit/license number, effective date, payment, date received) blank.

The form names no other channel, portal or in-person location. FillingPDF lets you fill out and download the PDF; submission follows the channels above.