Account Access - US Form

Account Access - US Form

Nicotine River is determined to follow the PACT Act diligently. We are requiring the following information on file from your company. If this form is not submitted, you may be unable to purchase nicotine products from our store. This form is for US businesses only.
Name *

First Name Last Name
Company Name *
Email *
example@example.com
Phone Number *
Please enter a valid phone number.
Primary Shipping Address *

Street Address

Street Address Line 2

City State

Zip Code
Please submit any (* required) or all of the following licenses or permits issued by your US state of operation. It is also a requirement that we receive any one or more of your state issued tobacco related licenses.

Business License*
Sellers Permit
Resale Certificate (if applicable)
Tobacco License(s)

The more licenses provided, the better. This is ultimately to ensure your account is compliant with all local and interstate regulations. Images of the licenses are required.
Licenses & Permits *

Cancel of
Federal EIN *
Have you registered with the ATF?

For more information regarding ATF registration please visit the official ATF website:

https://www.atf.gov/alcohol-tobacco/prevent-all-cigarette-trafficking-act-pact-2009
Please allow us 24 - 48 business hours to review your form. Once your form has been approved, your account will be activated for nicotine purchases.

For questions or concerns, please email: info@nicotineriver.com
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