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Tobacco Product Manufacturers Annual Certification - Georgia
| Tobacco Product Manufacturers Annual Certification Form. This is a Georgia form and can be used in Tobacco Product Manufacturer Office Of Attorney General Statewide . |
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STATE OF GEORGIA TOBACCO PRODUCT MANUFACTURER'S ANNUAL CERTIFICATION Pursuant To O.C.G.A. § 10-13A-3 For 2011 ----------------------------- and ----------------------------- Request For Listing In Georgia Directory Of Compliant Tobacco Product Manufacturers In 2012 Who is required to file this Certification? Any tobacco product manufacturer that sells, intends to sell or has sold cigarettes within the state of Georgia, whether directly or through any distributor, retailer, or similar intermediary, including manufacturers that are participants in the Master Settlement Agreement. You are required to submit this annual certification even if you submitted quarterly certifications during the 2011 sales year or had no sales during the 2011 sales year. Definitions: (a) "Brand Family" means all styles of Cigarettes sold under the same trade mark and differentiated from one another by means of additional modifiers or descriptors, including, but not limited to, "menthol," "lights," "kings," and "100s," and includes any brand name (alone or in conjunction with any other word), trademark, logo, symbol, motto, selling message, recognizable pattern of colors, or any other indicia of product identification identical or similar to, or identifiable with, a previously known brand of Cigarettes. "Cigarette" means any product that contains nicotine, is intended to be burned or heated under ordinary conditions of use, and consists of or contains (A) any roll of tobacco wrapped in paper or in any substance not containing tobacco; or (B) tobacco, in any form, that is functional in the product, which, because of its appearance, the type of tobacco used in the filler, or its packaging and labeling, is likely to be offered to, or purchased by, consumers as a cigarette; or (C) any roll of tobacco wrapped in any substance containing tobacco which, because of its appearance, the type of tobacco used in the filler, or its packaging and labeling, is likely to be offered to, or purchased by, consumers as a cigarette described in clause (A) of this definition. The term "cigarette" includes "roll-yourown" tobacco. 0.09 ounces of "roll-your-own" tobacco constitutes one individual cigarette. "Directory" means the Attorney General's list of all Tobacco Product Manufacturers that have provided current and accurate certifications conforming (b) (c) FORM AG-03 (Rev 03/12) 1 Doc # 665034 American LegalNet, Inc. www.FormsWorkFlow.com to the requirements of O.C.G.A. § 10-13A-3 and all Brand Families that are listed in such certifications. (d) "Qualified Escrow Fund" means an escrow fund established pursuant to an escrow agreement that has been approved by the Attorney General as being in compliance with OCGA § 10-13A-2(9). "Tobacco Product Manufacturer" means an entity that physically manufactures cigarettes anywhere in the world that are intended for sale in the United States, either directly or through an importer; an entity that is the first purchaser of cigarettes that the manufacturer did not intend to be sold in the United States, regardless of where those cigarettes were manufactured; or an entity that becomes a successor to an entity described above. "Unit" means one cigarette or .09 ounces of "roll your own" tobacco, as defined above. (e) (f) When is the escrow deposit due? The escrow deposit is due on Monday, April 16, 2012. When is this Certification due? This Certification must be received by us no later than Monday, April 30, 2012. Where do I send this Certification? The Certification must be delivered to two places: Consumer Interests Section Office of the Attorney General 40 Capitol Square Atlanta, Georgia 30334 And Georgia Department of Revenue Alcohol and Tobacco Tax Division 1800 Century Center Boulevard Atlanta, Georgia 30345-3205 INSTRUCTIONS Part 1: Manufacturer's Identification Enter your name, address, telephone, fax number, electronic mail address, and internet address. If you are located in the U.S., provide your federal tax identification number and TTB Tobacco Manufacturer Permit number. Provide your Georgia license number and the type of license. The Georgia Department of Revenue has licensing and additional reporting requirements for shipping any form of tobacco into Georgia. Contact the Department of Revenue directly for additional information at 404-417-4900 or atdiv@dor.ga.gov. FORM AG-03 (Rev 03/12) 2 Doc # 665034 American LegalNet, Inc. www.FormsWorkFlow.com Part 2: Certification Type Check whether this is an initial certification (if you are not currently listed), annual certification (due April 30, 2012 for 2011 sales), or supplemental certification (change of information previously provided). A. Brand Family Identification List by Brand Family all of the cigarettes that you sold or intend to sell in Georgia, whether directly or through any distributor, retailer, or similar intermediary and the number of individual cigarettes (units) sold in 2011 and 2012 to date. Only the brands you list will be included in the Directory. It is unlawful to offer for sale in Georgia any cigarette that is not compliant with the Georgia Fire Safety Standard & Firefighter Protection Act, O.C.G.A. § 24-4, et seq. ("fire safe" cigarette act). Accordingly, do not list a brand family unless the required information has been submitted to the Georgia Fire Safety Commissioner and required package markings approved. Participating Manufacturers shall include a list of their Brand Families. A Participating Manufacturer may not include a Brand Family in its certification unless it affirms that the Brand Family is deemed to be its cigarettes for purposes of calculating its payments under the Master Settlement Agreement for the relevant year, in the volume and shares determined pursuant to the Master Settlement Agreement. The Participating Manufacturer shall update such list thirty calendar days prior to any addition to or modification of its Brand Families by executing and delivering a supplemental certification to the Attorney General and the Department of Revenue. Non-Participating Manufacturers shall include the following in their certification: a list of all of its Brand Families, and the number of units for each Brand Family that were sold in Georgia during the preceding calendar year; a list of all of its Brand Families that have been sold in Georgia at any time during the current calendar year; indicate, by an asterisk (*), any Brand Family sold in Georgia during the preceding calendar year that is no longe
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