Form 1783 - South Dakota Tobacco Product Manufacturer Complementary Legislation Certification Page 3
Download a blank fillable Form 1783 - South Dakota Tobacco Product Manufacturer Complementary Legislation Certification 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 Form 1783 - South Dakota Tobacco Product Manufacturer Complementary Legislation Certification 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
4
5
6
7
8
9
10
11
12B.
Non-participating Manufacturer:
The Non-participating Manufacturer identified in Part 1 has the following brand families, each of which the tobacco product
manufacturer affirms are to be deemed its cigarettes for purposes of SDCL ch. 10-50B:
List all brand families sold in the preceding calendar year and at any time in the current calendar year.
Indicate by an asterisk (*) any brand no longer being sold in South Dakota as of the date of this
certification.
.09 oz. of RYO constitutes one unit. Attach additional sheets 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.
Units sold in
South Dakota in 2011 and
Previous Manufacturer
Brand Family Name
Cigarettes or Roll-Your-Own
to date in 2012, identified
(Name & Address)
separately
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.
Provide a sample of the current packaging of each brand within each brand family.
Check here if previously supplied packaging samples have not changed.
NOTE: If the manufacturer has previously supplied such packaging to the SD Department of Revenue and if such
packaging has not changed, samples need not be supplied this year.
III.
If located in the United States, provide a copy of the latest TTB Tobacco Manufacturer Permit.
IV.
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
3
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Tt-19-pm - Tobacco Product Manufacturer Certification For Participating Manufacturers
Financial
Form Tt-19-npm - Tobacco Product Manufacturer Certification For Non-participating Manufacturers - Commonwealth Of Virginia
Financial
Form Tt-19-npm - Tobacco Product Manufacturer Certification For Non-participating Manufacturers
Legal
Form Tt-19-pm - Tobacco Product Manufacturer Certification For Participating Manufacturers
Financial
Form Tt-19-npm - Tobacco Product Manufacturer Certification For Non-participating Manufacturers
Financial
Form Boe-501-tim - Tobacco Products Manufacturer/importer Return Of Taxable Distributions Of Samples In California
Financial
Related Categories
Parent category: Financial