Instructions For Form Tt-19-Npm - Virginia Department Of Taxation

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COMMONWEALTH OF VIRGINIA
Tobacco Product Manufacturer Certification for Non-Participating Manufacturers
Form TT-19-NPM
INSTRUCTIONS
Part 1:
Type of Certification.
Check the appropriate box. For Annual Certification, identify the current year.
Part 2:
Tobacco Product Manufacturer Identification.
Identify the full legal name of the entity, all other names ever used, Federal Employers
Identification Number, the Federal Tobacco Manufacturer Permint Number, physical
address, mailing address, principal phone number, contact person, title, telephone number,
facsimile number, electronic mail address, website, state and country where manufacturer
is incorporated or registered, and the names and titles of all past and present officers,
directors and partners.
If the entity is represented by outside counsel, identify the attorney's name, firm, address,
telephone number, facsimile number and electronic mail address.
Part 3:
Registered Agent for Service of Process within the Commonwealth of Virginia.
Identify the name of the Virginia registered agent, the name of the company, address,
telephone number, facsimile number and electronic mail address.
A current statement from the registered agent certifying service in this capacity must be
attached to the Certification.
Part 4:
Fabricator Identification.
Check the appropriate box to identify whether the Tobacco Product Manufacturer is the
actual physical fabricator of the Cigarettes or if the Tobacco Product Manufacturer causes
the Brand Family(s) to be fabricated by another entity.
If the Tobacco Product Manufacturer is not the actual physical fabricator, the name and
address of the actual fabricator must be provided and a copy of the manufacturing contract
must be attached to the Certification.
Provide a list of every Brand Family the Tobacco Product Manufacturer has fabricated, or
caused to be fabricated by another entity, since July 1, 1999 must be attached to the
Certification. Indicate with an asterisk (*) any Brand Family not being sold in the current
calendar year, and identify whether such Brand Family is still being manufactured and by
what entity.

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