Reminder Notice

OMB No.s: 0920-0210 and 0920-0338 Expiration Date: 02/28/2014
Burden: Public reporting burden of this collection of information is estimated to average 6.5 hours per response, including the time
for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information. 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. Send comments regarding this burden estimate or
any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance
Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0210 or 0920-0338).

on March 31 for the previous year. Additional information is available at CDC/OSH's Web page,
http://www.cdc.gov/tobacco/fclaa

Deadline: The Ingredient Report must be received upon initial importation and annually thereafter

Laboratory analysis in lieu of the Ingredient Report will not be accepted as it does not provide a complete
representation of the ingredients added to tobacco. By submitting an Ingredient Report you are certifying that
the manufacturer, and not a third party, has provided your company with the correct list of ingredients. Further,
if you are manufacturing or importing smokeless tobacco, then the Ingredient Report must also include nicotine
quantity for the product.

The Federal Cigarette Labeling and Advertising Act, 15 U.S.C. § 1335a, and the Comprehensive Smokeless
Tobacco Health Education Act, 15 U.S.C.§ 4403, require that every manufacturer, packager, and importer of
cigarettes and smokeless tobacco products submit a list of ingredients added during the manufacturing
process. This Ingredient Report must include the chemical name and chemical abstract service (CAS) registry
number for each ingredient listed.

Time to Submit Ingredient Report

REMINDER

Office on Smoking and Health
Centers for Disease Control and Prevention
Mailstop F-79
Attention: FCLAA Program Manager
4770 Buford Highway, N.E.
Atlanta, GA 30341-3717
OFFICIAL BUSINESS
Penalty for Private Use $300

Federal Cigarette Labeling and Advertising Act