Tobacco Product Manufacturer Certificate Of Compliance - Alabama Department Of Revenue
Download a blank fillable Tobacco Product Manufacturer Certificate Of Compliance - Alabama Department Of Revenue in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Tobacco Product Manufacturer Certificate Of Compliance - Alabama Department Of Revenue with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4A
D
R
TOB: TPM CERT
LABAMA
EPARTMENT OF
EVENUE
2/12
B
& L
T
D
USINESS
ICENSE
AX
IVISION
Reset
T
T
S
OBACCO
AX
ECTION
P.O. Box 327555 • Montgomery, AL 36132-7555 • (334) 242-9627
Tobacco Product Manufacturer Certificate of Compliance
For Sales Year 2011
P RT 1 – TOB CCO PRODUCT M NUF CTURER (TPM) IDENTIFIC TION
Company: __________________________________________________________________ FEIN:
Address: _____________________________________________________________________________________________________
City: ____________________________ State: _________________ Zip/Postal Code: ______________ Country: _________________
Telephone Number: (_______)_____________________________
FAX Number: (_______)________________________________
E-mail Address: _______________________________________________________________________________________________
Name and Title of Person Completing Report: _______________________________________________________________________
The Tobacco Product Manufacturer identified above is, as of the date of this Certification: (Initial One)
_______ A Participating Manufacturer under the Tobacco Master Settlement Agreement.
_______ A Tobacco Product Manufacturer in full compliance with Alabama Code Sections 6-12-3 and 6-12A-5(e).
P RT 2 – BR ND F MILY IDENTIFIC TION
Participating Manufacturers – complete Columns A & B; Non-Participating Manufacturers (NPM) – complete Columns A through E.
Attach additional sheets if necessary.
A.
B.
D.
E.
C.
BRAND FAMILY 1
BRAND NAME
HAS THIS
OTHER MANUFACTURER THAT
UNITS SOLD
BRAND BEEN
MANUFACTURED THE BRAND FAMILY IN THE
CERTIFICATION
SOLD IN 2012?
PRECEDING OR CURRENT CALENDAR YEAR
YEAR (2011)
(YES OR NO)
(NAME AND ADDRESS)
1
*
Indicate with an asterisk (
) those brands that will not be sold in Alabama as of the date of certification.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Tobacco Product Manufacturer Certificate Of Compliance - Alabama Department Of Revenue - 2004
Financial
Form Tt-19-npm - Tobacco Product Manufacturer Certification For Non-participating Manufacturers - Commonwealth Of Virginia
Financial
Form Tt-19-pm - Tobacco Product Manufacturer Certification For Participating Manufacturers
Financial
Related Categories
Parent category: Financial