Free CG-30.1 - New York

New York State Department of Taxation and Finance

Information Regarding Brands Sold in New York State
Attachment to Form CG-30
Legal name of manufacturer Date

CG-30.1
(2/09)
Federal employer identification number (EIN)

As required by New York State (NYS) Tax Law sections 480-b and 480-c, every tobacco product manufacturer must list each of its cigarette brands (including roll-your-own (RYO) tobacco) sold for consumption in NYS from January 1 of the prior calendar year until the date of this annual certification. In addition you must list any new brands of cigarettes and RYO tobacco which you intend to sell for consumption for the period covered by this certification prior to the first sale in NYS (see Form CG-30-I, Instructions for Forms CG-30, CG-30.1, and CG-30.2). Following is a list of brands sold for consumption in NYS by the above manufacturer for the period January 1, 20 through , 20 Tobacco product manufacturers who first introduce their products for sale in NYS must list the cigarette and roll-your-own (RYO) tobacco brands they intend to sell before making the first sale of these brands in NYS. Following is a list of brands to be sold for consumption in NYS by the above manufacturer effective , .
(month) (day) (year)

Page Complete brand names* RYO New Complete brand names*

of RYO New

* Be sure the complete brand name(s) of the cigarettes or RYO tobacco is listed, including the following (attach additional sheets if necessary):
·filteredorunfiltered ·descriptiveinformation(suchasmentholorslim) ·size(suchasregular,king,100's,etc.) ·ifbrandnameisanRYO,markanX in the RYO box ·ifbrandnameisanewbrand(s)ofcigarettesnotincludedonyourprior certification,markanX in the New box ·otherinformationasnecessarytoidentifytheproduct