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Department of Taxation and Finance
Application for Registration as a
Distributor of Alcoholic Beverages
Tax Law – Article 18
TP-215
(2/17)
I am applying for registration as a distributor of alcoholic beverages for the following (mark an X in the box for all that apply):
Liquor Beer Direct wine shipper Wine Cider
Read Form TP-215-I, Instructions for Form TP-215, before completing this form. Answer all questions. Attach additional sheets as necessary.
Section A – Business identication (complete all applicable elds; see instructions)
Legal name
DBA or trade name
(if different from legal name above) Federal employer ID number (EIN)
Address of principal place of business
(number and street; not a PO box)
City U.S. state / Canadian province County ZIP / Postal code Country
Mailing address (if different from business address)
City U.S. state / Canadian province ZIP / Postal code Country
Business number Fax number E-mail address
( ) ( )
Type of organization (mark an X in one or more boxes):
Sole proprietorship (individual) ......... Partnership ................................... Corporation ..............
Limited liability partnership (LLP) ..... Limited liability company (LLC) ..... Other
......................... (specify)
Do you elect to le annually?
Yes – I am eligible, and I elect to le my tax return on an annual basis rather than on a monthly basis (see instructions).
Indicate the number of liters (or gallons if wine, cider, or beer) you expect to sell per month.
Liquor, alcohol, and distilled or rectied spirits:
Over 24% alcohol by volume
.................................................................................................. liters
Over 2% but not over 24% alcohol by volume ......................................................................... liters
½% but not over 2% alcohol by volume .................................................................................. liters
Wine
(include sparkling and still) gallons Cider gallons Beer gallons
Are you registered as a New York State sales tax vendor?
Yes
No – You must apply and receive your NYS Certicate of Authority before this application will be approved for registration. You may apply online
by using the New York Business Express at www.businessexpress.ny.gov.
Do you have a State Liquor Authority (SLA) license?
Yes – Enter below the exact name, address, and identication number that appear on your New York State license.
No – You must be licensed by the SLA before your application can be approved (see instructions).
Application pending (see instructions).
Name License type License number
Number and street City State ZIP code
Section B – Other requirements
