Form ATF F 5070.1 ATF F 5070.1 Prevent All Cigarette Trafficking (PACT) Act Registratio

OMB No. 1140-xxxx (xx/xx/xxxx)

U.S. Department of Justice
Bureau of Alcohol,Tobacco, Firearms and Explosives

Prevent All Cigarette Trafficking (PACT) Act
Registration Form

Any person who sells, transfers, or ships for profit cigarettes or smokeless tobacco in interstate commerce, whereby such cigarettes or smokeless tobacco are shipped into a State, locality, or Indian country of an Indian tribe taxing the sale or use of cigarettes or smokeless tobacco or
who advertises or offers cigarettes or smokeless tobacco for such a sale, transfer, or shipment shall first file with the Attorney General of the
United States and with the tobacco tax administrators of the State and place into which such shipment is made, advertised, or offer is
disseminated.
1. Name of Person (See Definition #1)

2. Name of Person (If an Individual) (Last, first, middle)
Last
First

3. Trade Name(s)

Middle

4. Principal E-Mail Address

5. Number of Business Locations
6. Authorized Agent (Point of Contact) at Principal Location

7. Authorized Agent’s Telephone
Number

8. Principal Internet Address

9. Address(es) of All Business Locations
a. Street Address

City

State

Zip Code

9b. Street Address

City

State

Zip Code

9c. Street Address

City

State

Zip Code

9d. Street Address

City

State

Zip Code

Telephone Number at All
Locations
10a.
10b. Telephone Number

10c. Telephone Number

10d. Telephone Number

11a. Name of Authorized Agent at Each Business Location (Last, first, middle) 12a. Internet Address for Business
Last
First
Middle
13a. E-Mail Address
11b.
Last

12b. Internet Address for Business
First

Middle
13b. E-Mail Address

11c.
Last

12c. Internet Address for Business
First

Middle
13c. E-Mail Address

11d.
Last

12d. Internet Address for Business
First

Middle
13d. E-Mail Address

NOTE: In addition to registering with the Bureau of Alcohol, Tobacco, Firearms and Explosives, the PACT Act also requires a person to
register with each State tobacco tax administrator in which the person sells and/or advertises cigarettes and/or smokeless tobacco products.
ATF Form 5070.1
Revised (
)

Definitions
1. Person - The term “person” means an individual, corporation, company, association, firm, partnership, society, State government, local government,
Indian tribal government, governmental organization of such a government, or joint stock company.
2. Indian Tribe - The term “Indian tribe,” “tribe,” or “tribal,” refers to an Indian tribe as defined in section 4(e) of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 450b(e)) or as listed pursuant to section 104 of the Federally Recognized Indian Tribe List Act of 1994
(25 U.S.C. 479a-l).
Instructions
1. Provide the name of the “person” registering. Please refer to the definition of “person” provided.
2. Provide the “Name of the Person” if an individual is the registrant.
3. Provide all trade names used by the Person.
4. Provide the principal e-mail associated with the Person.
5. Provide the number of business locations associated with the Person.
6. Provide an authorized agent (point of contact) for the principal address of the Person.
7. Provide the telephone number for the authorized agent for the principal address.
8. Provide the principal internet address.
9. Provide the address for all business locations associated with the Person. (Please use ATF Form 5070.1A if additional space is
needed.)
10.Provide the telephone number for each additional business location. (Please use ATF Form 5070.1A if additional space is needed.)
11. Provide the name of an authorized agent for each additional business location. (Please use ATF Form 5070.1A if additional space is needed.)
12.Provide the internet address for each additional business location. (Please use ATF Form 5070.1A if additional space is needed.)
13. Provide the e-mail address for each point of contact for each additional business location. (Please use ATF Form 5070.1A if additional space is
needed.)

Paperwork Reduction Act Notice
The information required on this form is in accordance with the Paperwork Reduction Act of 1995. The purpose of the information is to
register delivery sellers of cigarettes and/or smokeless tobacco products with the Attorney General in order to legally continue to sell
and/or advertise these tobacco products. The information is mandatory as required by P.L. 111-154.
The estimated average burden associated with this collection is 1 hour per respondent or recordkeeper, depending on individual circumstances.
Comments about the accuracy of this burden estimate and suggestions for reducing it should be directed to Reports Management Officer, Document
Services, Bureau of Alcohol, Tobacco, Firearms and Explosives, Washington, DC 20226.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB
control number.

ATF Form 5070.1
Revised ( )