Form Tt-19-Pm - Tobacco Product Manufacturer Certification For Participating Manufacturers Page 2

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FORM TT-19-PM
Part 3: Brand Family Identification and Certification (attach supplemental pages if needed)
Actual and/or Previous Fabricator (if different
Brand Family
Brand Style(s)
from Tobacco Product Manufacturer)
• If the Tobacco Product Manufacturer is not the actual fabricator, identify by name and address the
company that contract manufactures that Brand Family. Also identify any Brand Family(s) the
Tobacco Product Manufacturer contract-manufactures for another company.
Rev. 02.01.05
Page 2 of 3

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