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1285 LICENSED DISTRIBUTOR REPORTING FORM AND INSTRUCTIONS FOR CIGARETTE SALES OF NON-PARTICIPATING MANUFACTURER

BRANDS – DEFINITIONS AND INSTRUCTIONS

As part of the Master Settlement Agreement between

“Non-participating Manufacturer” (NPM) means any

For cigarettes returned to the NPM, complete all columns

certain cigarette manufacturers and the State of

tobacco product manufacturer who is not a Participating

and enter the number of cigarettes in parenthesis. List

Colorado, the Department of Revenue is required and

Manufacturer (signatory) to the tobacco Master Settlement

brands returned on a separate line from brands sold during

authorized to compile information about cigarettes

Agreement dated November 23, 1998. A tobacco product

the reporting month.

and roll-your-own tobacco sold in Colorado. Refer

manufacturer ceases to be a non-participating manufacturer

Column C: Convert the number of ounces of NPM

to C.R.S. 39-28-201 to 203. Complete Form DR

upon entering into the Master Settlement Agreement. A

roll-your-own tobacco sold in Colorado into sticks by

1285 and submit it monthly if you are:

list of Participating Manufacturers and their brands may be

dividing the ounces by .09 and round to the nearest one.

obtained by visiting the department’s Web site at:

For roll-your-own tobacco returned to the NPM,

•

a cigarette distributor, and/or

or by calling the department at

complete all columns and enter the number of sticks in

•

a tobacco products distributor

(303) 205-8211, Ext. 6860 or Ext. 6858. The same list is

parenthesis.

also maintained and updated at the National Association of

List brands returned on a separate line from brands sold

Attorneys General (NAAG) Web site,

during the reporting month.

EFINITIONS

Column D: Enter the name and address of the Non-

INSTRUCTIONS

Participating Manufacturer of the brand listed in Column A.

“Cigarette” means any product that contains

Column E: Enter the name and address of the person

nicotine, is intended to be burned or heated under

This report must be completed for:

from whom each brand was purchased if different from the

ordinary conditions of use, and consists of or

•

Cigarettes manufactured by a NPM bearing the

person identified in Column D.

contains (I) any roll of tobacco wrapped in paper or

Colorado cigarette tax stamp.

Column F: Enter the name and address of the importer

in any substance not containing tobacco; or (II)

•

Roll-your-own tobacco, manufactured by a NPM sold

of the brand.

tobacco, in any form, that is functional in the

in Colorado.

Signature: Each report must be signed by an autho-

product, which, because of its appearance, the type

rized individual.

of tobacco used in the filler, or its packaging and

Enter the report month and year, your business name

Page Numbers: Enter the page number and total

labeling, is likely to be offered to, or purchased by,

and address as they appear on your license and your

number of pages included in the submission.

consumers as a cigarette; or (III) any roll of tobacco

Colorado Business Registration Number. Enter the name

Due Date: 20

day of each month following the close

wrapped in any substance containing tobacco, which,

and telephone number of the individual responsible for the

of the reporting month.

because of its appearance, the type of tobacco used

report. You must also include an email address.

in the filler or its packaging and labeling, is likely to

A separate form for each non-participating manufac-

Retain a copy for your files. Mail or fax completed form to:

be offered to, or purchased by, consumers as a

turer is preferable, but not required. A computer generated

cigarette described in clause (I) of this definition.

form is allowed ONLY if pre-approved by the department.

Colorado Department of Revenue

The term “cigarette” includes “roll-our-own” tobacco

Column A: Enter the full brand name of the product

Business Tax Accounting Section

(i.e., any tobacco, which, because of its appearance,

sold (do not abbreviate). Do not break down into sub-

1375 Sherman Street, Room 208

type, packaging, or labeling, is suitable for use and

categories, such as regular, menthol, light, etc. For ex-

Denver, CO 80261

likely to be offered to, or purchased by, consumers as

ample, for a cigarette named “Alpha Bravo Gold Menthol

FAX: (303) 866-3211

tobacco for making cigarettes). For purposes of this

Lights” report only “Alpha Bravo Gold”. Do not report as

definition of “cigarette,” 0.09 ounces of roll-your-

“A B Gold” or “A B Gold Menthol Light.”

own tobacco constitutes one individual “cigarette.”

Column B: Enter the number of individual NPM

“Tobacco Product Manufacturer” means any

FAILURE TO FILE THIS REPORT AS REQUIRED

cigarettes sold monthly in Colorado in packages bearing

person who meets the definitions found in C.R.S. 39-

MAY RESULT IN THE REVOCATION OF YOUR

the excise tax stamp of Colorado. List only cigarettes

28-201.

CIGARETTE AND/OR TOBACCO PRODUCTS

contained in packages to which you have affixed the excise

“Licensed Distributor” means any person who is

LICENSE(S) FOR A PERIOD OF TWO YEARS

tax stamp of Colorado. Do not list cigarettes that were

licensed pursuant to C.R.S. 39-28-102 (cigarette)

purchased with the tax stamp already affixed.

and/or 39-28.5-104 (tobacco products).

Dr 1285 Licensed Distributor Reporting Form And Instructions For Cigarette Sales Of Non-Participating Manufacturer Brands - Definitions And Instructions

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