Form Dr 0231 - Tobacco Product Manufacturer Certification (Page 2 of 10) in pdf

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This Certification and all other required forms must be completed in English. For all attachments required by the

Certification, if the original documents are in a language other than English, a true and correct translation into

English must be attached as well.

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Any attachments to this Certification must indicate to which Part and Question it corresponds.

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If any section of this Certification is not applicable to your company, be sure to check the box “not applicable”

where relevant or write “not applicable” if there is no box to check.

Records Retention Information

Tobacco Product Manufacturers are required to maintain all invoices and documentation of sales and other such

information relied upon for this certification for a period of 5 years, unless otherwise required by law to maintain them for a

greater period of time (C.R.S. § 39-28-303(1)(g).

Definitions:

(a) “Affiliate” means a person who directly or indirectly owns or controls, is owned or controlled by, or is under

common ownership or control with, another person. Solely for the purposes of this definition, the terms “owns”, “is

owned”, and “ownership” mean ownership of an equity interest, or the equivalent thereof, of ten percent (10%) or

more, and the term “person” means an individual, partnership, committee, association, corporation or any other

organization or group of persons.

(b) “Brand Family” means all brand styles of cigarettes sold under the same trademark and differentiated from one

another by means of additional modifiers or descriptors, including, but not limited to, “menthol,” “lights,” “kings,”

and “100s,” and includes any brand name (alone or in conjunction with any other word), trademark, logo, symbol,

motto, selling message, recognizable pattern of colors, or any other indicia of product identification identical or

similar to, or identifiable with, a previously known brand of cigarettes.

(d) “Directory” means the listing of all Tobacco Product Manufacturers that have provided current and accurate

certifications conforming to the requirements of § 39-28-303, C.R.S., and all brand families that are listed in such

certifications; except as provided by § 39-28-303, C.R.S.

(e) “Escrow Deposit” means deposits required to be made into a qualified escrow fund pursuant to § 39-28-203(2),

C.R.S.

(f) “Master Settlement Agreement” has the same meaning as in § 39-28-202(5), C.R.S.

(g) “ Non-participating Manufacturer” means any Tobacco Product Manufacturer that is not a Participating

Manufacturer.

(h) “Participating Manufacturer” has the meaning as in Section II(jj) of the Master Settlement Agreement and all

amendments thereto.

(i) “Qualified Escrow Fund” has the same meaning as defined in § 39-28-202(6), C.R.S.

(j) “Stamping Agent” or “Wholesaler” or “Distributor” means a person that is authorized to affix tax stamps to

packages or other containers of cigarettes under § 39-28-102, C.R.S., and/or any person that is required to pay

the tobacco tax imposed pursuant to § 39-28.5–101(7) on roll-your-own tobacco for cigarettes.

(k) “Tobacco Product Manufacturer” has the same meaning as defined in § 39-28-202(9), C.R.S.

(l) “Units Sold” has the same meaning as defined in § 39-28-202(10), C.R.S.

Form Dr 0231 - Tobacco Product Manufacturer Certification Page 2