Form 1783 - South Dakota Tobacco Product Manufacturer Complementary Legislation Certification Page 2
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12PART 2: BRAND FAMILY IDENTIFICATION (attach additional sheets if necessary)
A.
Participating Manufacturer:
The Participating Manufacturer identified in Part 1 has the following brand families, each of which the manufacturer
hereby affirms are to be deemed its cigarettes for the purposes of calculating its payments under the Master Settlement
Agreement, in the volume and shares determined pursuant to the Master Settlement Agreement:
Indicate with an asterisk (*) those brands that will not be sold in South Dakota as of the date of this
certification. (Attach additional sheet if necessary).
NOTE: The South Dakota Department of Revenue retains the discretion to determine that the cigarettes in a
brand family constitute cigarettes of another tobacco product manufacturer pursuant to SDCL 10-50-75.
Brand Family Name
Cigarettes or Roll-Your-Own
Brand Family Name
Cigarettes or Roll-Your-Own
Cigarettes
RYO
Cigarettes
RYO
Cigarettes
RYO
Cigarettes
RYO
Cigarettes
RYO
Cigarettes
RYO
Cigarettes
RYO
Cigarettes
RYO
Cigarettes
RYO
Cigarettes
RYO
Cigarettes
RYO
Cigarettes
RYO
Cigarettes
RYO
Cigarettes
RYO
Cigarettes
RYO
Cigarettes
RYO
I.
Are you requesting that all brand families above be listed on South Dakota’s directory?
Yes ____ No _____
NOTE: If the answer is “No,” then identify the brand families that you are not requesting to be listed:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
II.
For each of the above brand families (cigarettes only) provide a copy of the current Federal Trade
Commission (FTC) approval letter for health-warning rotation plan. Additional information can be
obtained at:
Federal Trade Commission
600 Pennsylvania Avenue, N.W.
Washington, D.C. 20580
General Information Locator: (202) 326-2222
III.
For each of the above brand families (cigarettes only) provide a copy of the current Center for Disease
Control (CDC) ingredient listing compliance letter(s) and a statement as to which brand’s ingredients were
submitted for each approval letter. Additional information can be obtained at:
Centers for Disease Control and Prevention
1600 Clifton Road
Atlanta, GA 30333
Telephone: 1-800-311-3435
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