Form 55b - Tobacco Product Manufacturer'S Certification - 2017 Page 10
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10Checklist and Mailing
Prior to mailing, please check that the following has been provided:
A current listing of all UPC codes of cigarettes and RYO products that are manufactured by your company;
c
Brand Family Packaging or Labeling (if required);
c
Compliance Document Regarding Ingredient list;
c
Approval Letter Regarding Rotation Plan;
c
c
Manufacturer’s Permit Under 26 U.S.C. § 5713;
Signature; and
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Notary.
c
In the case of a nonparticipating manufacturer, please check that the following have also been provided:
Statement from Registered Agent of Manufacturer;
c
Consent to be Sued with Attachments;
c
Acceptance of Joint and Several Liabilty with Attachments (foreign manufacturer only);
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Tobacco Tax Bureau Form 5210.5 or 5220.6;
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NPM Bond Documentation;
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Bond Continuation Certificate;
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New Model Escrow Agreement and Amendments if required; and
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Account Statement with Complete History.
c
Mail the original completed Certification (with all
Mail or email a copy of the Certification to:
attachments) to:
Cliff Thomas, Tax Specialist Sr.
Office of the Nebraska Attorney General
Nebraska Department of Revenue
Attn: Consumer Protection Division
PO Box 94818
2115 State Capitol
Lincoln, NE 68509-4818
PO Box 98920
cliff.thomas@nebraska.gov
Lincoln, NE 68509-8920
Note: Incomplete and/or illegible Certification forms and any attachments will be returned.
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Parent category: Legal