Form Dr 0231 - Tobacco Product Manufacturer Certification (Page 3 of 10) in pdf

Specific Instructions

Part 1: Manufacturer’s Identification

Section 39-28-202(9), C.R.S., sets forth three circumstances under which an entity is a Tobacco Product Manufacturer.

Those circumstances are set out in Questions 1-3. If an applicant answered “no” to Questions 1, 2, and 3, Applicant must

provide an explanation for its assertion that it is a Tobacco Product Manufacturer in its response to Question 4.

Part 2: Certification Year

Identify the year for which certification is being requested.

Part 3: Brand Family Identification

Identify by brand family and brand style, all cigarettes that the Tobacco Product Manufacturer intends to sell in Colorado,

whether directly or through any distributor, retailer, or similar intermediary, and seeks to have included in the directory.

Only the brands identified will be included in the directory.

A Tobacco Products Manufacturer (TPM) shall include in its certification (1) a list of all of its brand families that were sold

in Colorado during the preceding calendar year, (2) indicating, by an asterisk, any brand family sold in Colorado during

the preceding calendar year that is no longer being sold in Colorado as of the date of such certification, (3) a list of all

of its brand families that have been sold in Colorado at any time during the current calendar year and (4) the name and

address of any other manufacturer of such brand families in the preceding or current calendar year. The TPM shall update

such list thirty calendar days prior to any addition to or modification of its brand families by executing and delivering a

Supplemental Certification to the Attorney General and the Department of Revenue.

All Manufacturers, who have provided written certification pursuant to § 24-33.5-1214, C.R.S., must indicate

for each brand family when it was certified as fire-safe. All Non-Participating Manufacturers must also file a

Certificate of Compliance by Non-Participating Manufacturer Regarding Escrow Payment.

F.1.Submit samples of the actual packaging and labeling, preferably on CD, for each brand of Cigarettes

that Applicant intends to sell in Colorado. If packaging has not changed from prior certifications, it need not

be resubmitted.

F.2. Cigarette Health Warning Rotation Plan—A copy of the current Federal Trade Commission (“FTC”) letter

authorizing your health warning rotation plan must be provided for the brand families you currently sell in the

State of Colorado. Additional information can be obtained from:

Federal Trade Commission

600 Pennsylvania Avenue, N.W.

Washington, D.C. 20580

General Information Locator: 202-326-2222

F.3. Cigarette Ingredient Reporting Requirement—A copy of the current Centers for Disease Control (CDC) letter

approving your ingredient listing for cigarettes must be provided for the brand families you currently sell in the

State of Colorado. Additional information can be obtained from:

Centers for Disease Control and Prevention

1600 Clifton Road

Atlanta, Georgia 30333

1-800-CDC-INFO (232-4636)

Form Dr 0231 - Tobacco Product Manufacturer Certification Page 3