Form Tob: Reg - Tobacco Products Registration Form - State Of Alabama Page 2

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16. List suppliers name(s) and address(es) (attach additional sheets if necessary):
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
17. Are you a wholesaler or retailer?
Wholesaler
Retailer
18. List counties in which you plan to conduct business:
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
19. Are your suppliers, listed in item 14, personally soliciting your business?
Yes
No
20. How are deliveries of tobacco products made to you?
Supplier’s Vehicle
Common Carrier
Mail Order
Other (please explain) ________________________________________________________________________
______________________________________________________________________________________________

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