Prevent All Cigarette Trafficking (Pact) Act Tennessee Registration Form
ADVERTISEMENT
1
2Prevent All Cigarette Trafficking (PACT) Act
Tennessee Registration Form
Any person who sells, transfers, or ships for profit cigarettes or smokeless tobacco in interstate commerce, whereby such
cigarettes or smokeless tobacco are shipped into a State, locality, or Indian country of an Indian tribe taxing the sale or use of
cigarettes or smokeless tobacco or who advertises or offers cigarettes or smokeless tobacco for such a sale, transfer, or
shipment is made, advertised, or offer is disseminated.
1. Name of Person (See Definition #1)
2. Federal Employer Identification
Number (if not an individual)
Last
First
Middle
3. Trade Name(s)
4. Principal Email Address
5. Number of Business Locations
6. Authorized Agent (Point of Contact) at Principal
7. Authorized Agent’s Telephone
8. Principal Internet Address
Location
Number
9. Tennessee Registered Agent
Registered Agent’s Address
Registered Agent’s Telephone
10. List Business Locations
Street Address
City
State
Zip Code
Telephone
11. Authorized Agent at each Business Location (Last, First, Middle)
Last
First
Middle
Internet Address For Business
Email Address For Business
Last
First
Middle
Internet Address For Business
Email Address For Business
Last
First
Middle
Internet Address For Business
Email Address For Business
Last
First
Middle
Internet Address For Business
Email Address For Business
Form
Revised March 2011
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal