Form Dr 1285 - Licensed Distributor Reporting Form For Cigarettes Sales Of Non-Participating Manufacturer Brands Page 2
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2DR 1285 LICENSED DISTRIBUTOR REPORTING FORM AND INSTRUCTIONS FOR CIGARETTE SALES
OF NON-PARTICIPATING MANUFACTURER BRANDS - DEFINITIONS AND INSTRUCTIONS
As part of the Master Settlement Agreement between
Settlement Agreement dated November 23, 1998.
brands returned on a separate line from brands sold
certain cigarette manufacturers and the State of Colo-
A tobacco product manufacturer ceases to be a non-
during the reporting month.
rado, the Department of Revenue is required and au-
participating manufacturer upon entering into the Mas-
Column C: Convert the number of ounces of NPM
thorized to compile information about cigarettes and roll-
ter Settlement Agreement. A list of Participating Manu-
roll-your-own tobacco sold in Colorado into sticks by
your-own tobacco sold in Colorado. Refer to C.R.S. 39-
facturers and their brands may be obtained by visiting
dividing the ounces by .09 and round to the nearest
28-201 to 203. Complete Form DR 1285 and submit it
the department’s Web site at: or
one.
monthly if you are:
by calling the department at (303) 205-8211, Ext. 6860
For roll-your-own tobacco returned to the NPM, com-
•
a cigarette distributor/wholesaler, and/or
or Ext. 6848. The same list is also maintained and up-
plete all columns and enter the number of sticks in pa-
•
a tobacco products distributor/wholesaler
dated at the National Association of Attorneys General
renthesis.
(NAAG) Web site,
List brands returned on a separate line from brands
DEFINITIONS
sold during the reporting month.
“Cigarette” means any product that contains nicotine,
INSTRUCTIONS
Column D: Enter the name and address of the Non-
is intended to be burned or heated under ordinary con-
This report must be completed for:
participating Manufacturer of the brand listed in Col-
ditions of use, and consists of or contains (I) any roll of
• Cigarettes manufactured by a NPM bearing the
umn A.
tobacco wrapped in paper or in any substance not con-
Colorado cigarette tax stamp.
Column E: Enter the name and address of the person
taining tobacco; or (II) tobacco, in any form, that is func-
• Roll-your-own tobacco, manufactured by a NPM
from whom each brand was purchased if different from
tional in the product, which, because of its appearance,
sold in Colorado.
the person identified in Column D.
the type of tobacco used in the filler, or its packaging
Enter the report month and year, your business name
Column F: Enter the name and address of the im-
and labeling, is likely to be offered to, or purchased by,
and address as they appear on your license and your
porter of the brand.
consumers as a cigarette; or (III) any roll of tobacco
Colorado Business Registration Number. Enter the
Signature: Each report must be signed by an autho-
wrapped in any substance containing tobacco, which,
name, telephone number, and FAX number, of the indi-
rized individual.
because of its appearance, the type of tobacco used in
vidual responsible for the report. An E-mail address is
Page Numbers: Enter the page number and total num-
the filler or its packaging and labeling, is likely to be
required. C.R.S. 39-28-303(2)(c).
ber of pages included in the submission.
offered to, or purchased by, consumers as a cigarette
A separate form for each non-participating manufac-
Due Date: 20
day of each month following the close
TH
described in clause (I) of this definition. The term “ciga-
turer is preferable, but not required. A Computer gener-
of the reporting month.
rette” includes “roll-your-own” tobacco (i.e., any tobacco,
ated form is allowed ONLY if pre-approved by the De-
Retain a copy for your files. Mail (mail separately– do
which, because of its appearance, type, packaging, or
partment.
not include this form with other forms or reports mailed
labeling, is suitable for use and likely to be offered to, or
Column A: Enter the full brand name of the product
to the Department of Revenue), or fax completed form
purchased by, consumers as tobacco for making ciga-
sold (do not abbreviate). Do not break down into sub-
to:
rettes). For purposes of this definition of “cigarette,” 0.09
categories, such as regular, menthol, light, etc. For ex-
Colorado Department of Revenue
ounces of roll-your-own tobacco constitutes one indi-
ample, for a cigarette named “Alpha Bravo Gold Men-
Excise Tax Accounting Section
vidual “cigarette.”
thol Lights” report only “Alpha Bravo Gold”. Do not re-
1375 Sherman Street, Room 237
“Tobacco Product Manufacturer” means any per-
port as “A B Gold” or “A B Gold Menthol Light.”
Denver, CO 80261
son who meets the definitions found in C.R.S. 39-28-
Column B: Enter the number of individual NPM ciga-
FAX: (303) 205-8215
201.
rettes sold monthly in Colorado in packages bearing
“Licensed Distributor” means any person who is
the excise tax stamp of Colorado. List only cigarettes
licensed pursuant to C.R.S. 39-28-102 (cigarette) and/
contained in packages to which you have affixed the
or 39-28.5-104 (tobacco products).
excise tax stamp of Colorado. Do not list cigarettes that
FAILURE TO FILE THIS REPORT AS REQUIRED
“Non-participating Manufacturer” (NPM) means any
were purchased with the tax stamp already affixed. For
MAY RESULT IN THE REVOCATION OF YOUR
tobacco product manufacturer who is not a Participat-
cigarettes returned to the NPM, complete all columns
CIGARETTE AND/OR TOBACCO PRODUCTS
ing Manufacturer (signatory) to the tobacco Master
and enter the number of cigarettes in parenthesis. List
LICENSE(S) FOR A PERIOD OF TWO YEARS
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