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Form TPM-1 Instructions

Tobacco product manufacturer means any entity, which after

Who Must File

July 1, 2000, directly and not exclusively through an afﬁ liate:

Each nonparticipating manufacturer selling cigarettes to

consumers within Connecticut, whether directly or through a

a. Manufactures cigarettes anywhere which the manufacturer

distributor, dealer, or similar intermediary or intermediaries,

intends to be sold in the United States, including

cigarettes intended to be sold in the United States through

must establish a qualiﬁ ed escrow fund for the beneﬁ t of

the State of Connecticut and other settling states, place the

an importer;

required amount of money into a qualiﬁ ed escrow fund, and

b. Is the ﬁ rst purchaser anywhere for resale in the United

ﬁ le Form TPM-1, Certiﬁ cation of Compliance and Afﬁ davit

States of cigarettes manufactured anywhere that the

by Nonparticipating Manufacturer.

manufacturer does not intend to be sold in the United

States; or

Deﬁ nitions

c. Becomes a successor of an entity described above.

Cigarette means any product that contains nicotine, is

intended to be burned or heated under ordinary conditions

Master Settlement Agreement means the agreement that

of use, and consists of or contains:

the settling states and the original participating manufacturers

a. Any roll of tobacco wrapped in paper or in any substance

entered into on November 23, 1998. Under MSA, the parties

not containing tobacco;

settled and resolved all claims by the settling states directly

or indirectly based on the sale, distribution, manufacture,

b. Tobacco, in any form, that is functional in the product,

development, advertising, and marketing of tobacco products

which because of its appearance, the type of tobacco used

by the participating manufacturers. MSA required, among

in the ﬁ ller, or its packaging and labeling, is likely to be

other things, each of the settling states enact a model statute.

offered to or purchased by consumers as a cigarette; or

c. Any roll of tobacco wrapped in any substance containing

Settling states means the 46 states, including Connecticut,

tobacco, which because of its appearance, the type of

that signed the MSA on or before November 23, 1998.

tobacco used in the ﬁ ller, or its packaging and labeling,

Qualiﬁ ed escrow fund means an escrow arrangement with

is likely to be offered to or purchased by consumers as

a federally or state-chartered ﬁ nancial institution having

a cigarette described in (a).

no afﬁ liation with any tobacco product manufacturer. The

For purposes of this form:

ﬁ nancial institution must have assets of at least $1 billion.

1. Each nine one-hundredths (0.09) of an ounce of

The escrow arrangement must require that the ﬁ nancial

roll-your-own cigarette tobacco also constitutes one

institution hold the principal of the escrowed funds for the

individual cigarette.

beneﬁ t of releasing parties (generally, the settling states) and

2. A small cigar properly treated as a cigarette for

prohibit the tobacco product manufacturer that placed the

purposes of the federal excise tax on cigarettes

funds into escrow from using, accessing, or directing the use

(26 U.S.C. §5701(b)) should be reported as a cigarette

of the principal of the funds except as consistent with Conn.

on Form TPM-1, but a small cigar properly treated as

Gen. Stat. §4-28i(b).

a small cigar for purposes of the federal excise tax on

When and Where to File

cigars (26 U.S.C. §5701(a)(1)) should not be reported as

On or before April 15, 2011, the nonparticipating

a cigarette on Form TPM-1.

manufacturer must place the required amount of money into

Nonparticipating manufacturer means any tobacco product

a qualiﬁ ed escrow fund.

manufacturer that is not a participating manufacturer.

On or before April 30, 2011, the nonparticipating

Participating manufacturers means and includes the original

manufacturer must send Form TPM-1, Form TPM-3, Brand

participating manufacturers and subsequent participating

Families Unit Sales Schedule, and a copy of the escrow

manufacturers.

agreement signed by the nonparticipating manufacturer

and the ﬁ nancial institution to the following address:

Original participating manufacturers means Brown

Ofﬁ ce of the Attorney General

& Williamson Tobacco Corporation, Lorillard Tobacco

Finance Department

Company, Philip Morris Incorporated, R.J. Reynolds Tobacco

PO Box 120

Company, and their respective successors.

Hartford CT 06141-0120

Subsequent participating manufacturer means a tobacco

For further information contact:

product manufacturer that becomes a signatory to the

Ofﬁ ce of the Attorney General

Master Settlement Agreement (MSA) but is not an original

State of Connecticut

participating manufacturer.

860-808-5270

Form TPM-1 Back (Rev. 03/11)

Form Tpm-1 - Certification Of Compliance And Affidavit By Non Participating Manufacturer - 2010 Page 2

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