Form 55b - Tobacco Product Manufacturer'S Certification - 2017 Page 5
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10Part 3: Business and Ownership Information of the Tobacco Product Manufacturer
A. Fabrication of Brand Families
Does the tobacco product manufacturer identified in Part 1 itself fabricate the brand families
c
c
identified in Part 2A or 2B?
Yes
No
If no, please explain the basis for the tobacco product manufacturer’s submission of this Certification.
B. Manufacturing Facility Identification:
Address of Manufacturing Plants
Name of Factory Managers
Phone Number of Factory Managers
Fax Number of Factory Managers
C. Access to Manufacturing Facility
Do other companies have access to or utilize any of the manufacturing facilities identified in Part 3B? Yes
c
No
c
If yes, please explain:
D. Criminal Activity
Has the tobacco product manufacturer identified in Part 1 or any of its affiliates, sales entity affiliates,
officers, or directors been convicted of a felony crime relating to the sale or taxation of cigarettes or
tobacco products?
Yes
c
No
c
If yes, please explain:
E. Jenkins Act Compliance
Does the tobacco product manufacturer identified in Part 1 affirmatively certify that it is in full
compliance with all of the registration and reporting requirements of 15 U.S.C. §§ 376 and 376a,
commonly referred to as the Pact Act?
Yes
c
No
c
If no, please explain:
F. Directory Status
Have either the tobacco product manufacturer identified in Part 1 or any of its brand families ever
been involuntarily removed from the approved-for-sale tobacco products directory of any state?
Yes
c
No
c
If yes, please explain:
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