Fireworks Application

Request to Schedule Inspection

Applicant Name
Mailing Address
License Type
Amount for licensed manufacturer, distributor or wholesaler retail permit book only.
Physical Address of Sales Location
Contact Person at Sales Location
Primary Supplier Address
Type of Structure

By typing my name above I agree that the information provided on and with this form is true and correct to the best of my knowledge and belief. I have read, reviewed and understand the New Mexico laws and rules regarding the safe packaging, handling and sale of fireworks. I agree to fully comply with these laws and rules as a condition of obtaining and operating pursuant to a fireworks license or permit. I understand that the approval of this application depends upon compliance with the provisions of Article 2C of the Fireworks Licensing & Safety Act, NMSA 1978, §§60-2C-1 to 60-2C-11 (1999). In the event that my license or permit is lost or destroyed, I understand that I shall immediately notify the State Fire Marshal’s office and not be entitled to a refund of the original application fees, but must submit a new application and pay a $20.00 replacement fee for the type of license or permit at the location. However, I understand that state law does not permit the acceptance applications during the holiday selling period.
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