Tobacco Product Manufacturer Certificate Of Compliance Form - 2010 Page 4
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4Part 2: Brand Family Identification. Identify by Brand Family and Brand Name all of the cigarettes that the Tobacco Product Manufacturer
intends to sell in this State whether directly or through any distributor, retailer, or similar intermediary, and seeks to have included in the
Directory. Only the brands identified may be included in the Directory.
A Participating Manufacturer shall include a list of its Brand Families. The Participating Manufacturer shall update such list thirty calen-
dar days prior to any addition to or modification of its Brand Families by executing and delivering a supplemental certification to the
Commissioner of the Alabama Department of Revenue.
A Non-Participating Manufacturer shall include in its certification (i) a list of all of its Brand Families and the number of Units Sold for
each Brand Family that were sold in the State during the certification year, (ii) an answer of yes or no as to whether or not the Brand
Families have been sold in the State during the calendar year following the certification year, (iii) indication, by an asterisk, of any Brand
Family sold in the State during the preceding calendar year that is no longer being sold in the State as of the date of such certification,
and (iv) identification by name and address any other manufacturer of such Brand Families in the preceding or current calendar year.
The Non-Participating Manufacturer shall update such list thirty calendar days prior to any addition to or modification of its Brand Families
by executing and delivering a supplemental certification to the Commissioner of the Alabama Department of Revenue.
Part 3: Non-Participating Manufacturer Certification.
process and provided notice thereof as required by Section 6-12A-4, Code of Alabama 1975.
A. Verify that the Non-Participating Manufacturer is registered to do business in Alabama or has appointed an agent for service of
lished a Qualified Escrow Fund pursuant to Section 6-12-3, Code of Alabama 1975 and all regulations promulgated thereto; (ii) the
B. Identify (i) the name, address and telephone number of the financial institution where the Non-Participating Manufacturer has estab-
account number of such Qualified Escrow Fund and any sub-account number for Alabama.
C. Identify (i) the amount such Non-Participating Manufacturer placed in such fund for cigarettes sold in the State during the preceding
calendar year, the date and amount of each such deposit; and (ii) the amount and date of any withdrawal or transfer of funds the Non-
Participating Manufacturer made at any time from such fund or from any other Qualified Escrow Fund.
Part 4: Signature. The person executing the Certification must do so before an authorized notary public who must also sign and date
the Certificate.
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