Form Com/fed-304 - Schedule Of Planned Promotional Activities

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Comptroller of Maryland

Field Enforcement Division

P.O. Box 2397

Q Original Report

Annapolis, Maryland 21404

410-260-7388/888-674-0017

Q Amended Report

Fax#410-974-5564

Amended Date _____________

Schedule of Planned Promotional Activities

For Month of

Year

A. Name of Primary Sponsor:

Address:

License/permit #:

B. Name of Wholesaler:

Address:

License/permit #:

C. Name of Brand Owner:

Address:

License/permit #:

D. Product(s) Promoted:

E. Type of Promotional Activity:

F. Description of Promotion:

G. Promotion Coordinator/Responsible Manager (The primary coordinator must be an authorized employee or representative of the brand owner or wholesaler.)

Name:

Solicitor Permit #:

Title:

Telephone #:

H. List all non-licensed third parties, charitable groups and/or model agencies that will be involved in conducting or promoting these activities:

(On page 2 list retail accounts where this particular promotion will be held.)

I. I certify that the information contained in this report is true and accurate to the best of my knowledge and belief and that any changes or modifications will

be promptly reported. On behalf of the primary sponsor, I understand that we will be held accountable for complying with all laws, regulations, and

guidelines when conducting or participating in this activity.

_______________________________________________

____________________________________

______________________________

Signature of Responsible Manager

Title

Date

_______________________________________________

____________________________________

Print or Type Name

Telephone Number