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Non-Participating Manufacturers Sales Information Form. This is a New Jersey form and can be use in Office Of The Attorney General Statewide.
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Tags: Non-Participating Manufacturers Sales Information, NPM-S, New Jersey Statewide, Office Of The Attorney General
State of New Jersev
.
Non-Participating Manufacturer's
Sales Information
NPM-S
Company Name
Mailing Address
City
Stale
Zip Code
Phone
Country
Fax
Name and title of
per
SOil completing this fi:rii
Mail-to Address
(if different from above)
Name
Mailing Address
CÍIy
Slalê
Zip Code
Phone
Fax
E.jll1ai¡
I Couniry
Certilcation Year
D
2011 10,,1"
D
Other:
made in 2010
Instrnctions for the Manufacturer ("You"):
(Anach Addendum pages as necessary)
Instructions for the rvlanufacturer: List each distributor, wholesale dealer and retailer which sells your product(s) in the State of
New Jersey. For each distTibutol, wholesale dealer and retailer, provide the sales volume according to your records for each brand
name and family for the liability year and provide copies of invoices or other documents that support the sales volume listed, In
addition, provide the name, address, and phone number for the contact person at each distributor, wholesale dealer and retailer
provided. Finally provide information regarding flavoring; identifY flavors other than menthol, clove or tobacco.
You must retain all invoices and documentation of sales and other infonnation relied upon for a period of 5 years, unless othenvise
required by law to maintain them for a greater period of
time.
Flavoring* (Identify flavors
Distributor /
Wholesale dealer /
Retailer
Brand Name
Brand Family
Check One
other than Menthol, Clove or
Tobacco)
o Cigarette
o RYO
o Cigarette
o RYQ
o Cigarette
o RYO
o Cigarette
o RVO
*In no event shall cigarettes or any component part thereof
that causes a cigarettes or smoke from that product to have a characterizing
flavor other than tobacco, clove or menthol to be sold or advertised in this State. N.J.5.A. 2A: 170-51.6
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State of New Jersey
Non-Participating Manufacturer's
Sales Information
Sales
Addendum
Flavoring* (Identify flavors
Distributor I
Wholesale dealer /
Retailer
NPM-S
Brand Name
Brand Family
Check One
other than Menthol, Clove or
Tobacco)
o Cigarette
o RYO
o Cigarette
o RYO
o Cigarette
o RYO
o Cigarette
o RYO
o Cigarette
o RYO
o Cigarette
o RYO
o (¡garette
o RYO
o Cigarette
o RYO
o Cigarette
o RYO
o Cigarette
o RYO
o Cigarette
o RYO
o Cigarette
o RYO
o Cigarette
o RYO
o Cigarette
o RYO
o Cigarette
o RYO
*In no event shall cigarettes or any component part thereof
that causes a cigarettes or smoke from that product to have a characterizing
flavor other than tobacco, clove or menthol to be soid or advertised in this State. N.J.SA 2A: 170-51.6
American LegalNet, Inc.
www.FormsWorkFlow.com
