Form Tt-19-Npm - Tobacco Product Manufacturer Certification For Non-Participating Manufacturers Page 3
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6FORM TT-19-NPM
Part 5: Brand Family Identification and Certification
A. Brand Family(s) (attach supplemental pages if needed)
Units Sold in Virginia in
Actual and/or Previous Fabricator (if different
Brand Family
Previous Calendar Year
from Tobacco Product Manufacturer)
TOTAL:
• For each Brand Family, list every Brand Style for which certification is being sought.
• For each Brand Style, actual packaging must be included with the original Certification submitted
to the Attorney General. If the Tobacco Product Manufacturer has previously submitted such
packaging and such packaging has not been changed, no resubmission is required.
□
Tobacco Product Manufacturer's previously submitted packaging for each brand family has not been changed.
Rev. 02.01.05
Page 3 of 6
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