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AG PM-1 Brand Addendum LY2024 updated 1.24.2025.pdf
State of Illinois
Certification of Participating Manufacturer
PM-1
Brands
Addendum
Manufacturer Identification
Company Name Brands Addendum Page ____ of ____
Part 4: Brand Family Certification (Attach addendum pages to PM-1 Certification...
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AG PM-1 Brand Addendum LY2023 updated 2.21.24.pdf
State of Illinois
Certification of Participating Manufacturer
PM-1
Brands
Addendum
Manufacturer Identification
Company Name Brands Addendum Page ____ of ____
Part 4: Brand Family Certification (Attach addendum pages to PM-1 Certification...
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AG PM-1 Brand Addendum LY2022 updated 2.9.23.pdf
State of Illinois
Certification of Participating Manufacturer
PM-1
Brands
Addendum
Manufacturer Identification
Company Name Brands Addendum Page ____ of ____
Part 4: Brand Family Certification (Attach addendum pages to PM-1 Certification...
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AG PM-1 Brand Addendum LY2021 updated 22422.pdf
State of Illinois
Certification of Participating Manufacturer
PM-1
Brands
Addendum
Manufacturer Identification
Company Name Brands Addendum Page ____ of ____
Part 4: Brand Family Certification (Attach addendum pages to PM-1 Certification...
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AG NPM-R Reconciliation Affidavit LY2024 updated 1.24.2025.pdf
State of Illinois
Affidavit of Non-Participating Manufacturer
Regarding Escrow Reconciliation Payment
NPM-R
Part 1: Manufacturer Identification Part 2: Liability Year
Name: The liability period for this Affidavit is:
Street Address: 2024...
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AG NPM-R Reconciliation Affidavit LY2023 updated 3.1.24.pdf
State of Illinois
Affidavit of Non-Participating Manufacturer
Regarding Escrow Reconciliation Payment
NPM-R
Part 1: Manufacturer Identification Part 2: Liability Year
Name: The liability period for this Affidavit is:
Street Address: 2023...
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AG NPM-R Reconciliation Affidavit LY2022 updated 3.1.23.pdf
State of Illinois
Affidavit of Non-Participating Manufacturer
Regarding Escrow Reconciliation Payment
NPM-R
Part 1: Manufacturer Identification Part 2: Liability Year
Name: The liability period for this Affidavit is:
Street Address: 2022...
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AG NPM-R Reconciliation Affidavit LY2021 updated 3.3.22.pdf
State of Illinois
Affidavit of Non-Participating Manufacturer
Regarding Escrow Reconciliation Payment
NPM-R
Part 1: Manufacturer Identification Part 2: Liability Year
Name: The liability period for this Affidavit is:
Street Address: 2021...
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AG NPM-Q LY2024 updated 1.24.2025.pdf
NPM-Q
p. 1 of 3
Part 1: Liability Reporting Period
The liability period for this affidavit is: (check one)
2024
Jan.-Mar.
Due Apr. 30
Apr.-Jun.
Due Jul. 31
Jul.-Sep.
Due Oct. 31
Oct.-Dec....
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AG NPM-Q LY2023 updated 3.1.24.pdf
NPM-Q
p. 1 of 3
Part 1: Liability Reporting Period
The liability period for this affidavit is: (check one)
2023
Jan.-Mar.
Due Apr. 30
Apr.-Jun.
Due Jul. 31
Jul.-Sep.
Due Oct. 31
Oct.-Dec....
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AG NPM-Q LY2022 updated 3.1.23.pdf
NPM-Q
p. 1 of 3
Part 1: Liability Reporting Period
The liability period for this affidavit is: (check one)
2022
Jan.-Mar.
Due Apr. 30
Apr.-Jun.
Due Jul. 31
Jul.-Sep.
Due Oct. 31
Oct.-Dec....
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AG NPM-Q LY2021 updated 3.1.22.pdf
NPM-Q
p. 1 of 3
Part 1: Liability Reporting Period
The liability period for this affidavit is: (check one)
2021
Jan.-Mar.
Due Apr. 30
Apr.-Jun.
Due Jul. 31
Jul.-Sep.
Due Oct. 31
Oct.-Dec....
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AG NPM-PACT updated 3322.pdf
State of Illinois
Non-Participating Manufacturer
Certification of PACT Act Information
Please Review PACT Act Notice
NPM-PACT
Part 1: Liability Year and Type of Certification
Liability Year for this Certification: Complete a separate form for...
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AG NPM-PACT updated 3.1.23.pdf
State of Illinois
Non-Participating Manufacturer
Certification of PACT Act Information
Please Review PACT Act Notice
NPM-PACT
Part 1: Liability Year and Type of Certification
Liability Year for this Certification: Complete a separate form for...
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AG NPM-LC updated 3.3.22.pdf
State of Illinois
Non-Participating Manufacturer
Certification of Little Cigar/Cigarette
NPM-LC
p. 1 of 2
Part 1: Manufacturer Identification
Company Name LY:2021
Part 2: Sales of Cigars
For each brand family of cigars that are...
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AG NPM-LC updated 3.1.24.pdf
State of Illinois
Non-Participating Manufacturer
Certification of Little Cigar/Cigarette
NPM-LC
p. 1 of 2
Part 1: Manufacturer Identification
Company Name LY:2023
Part 2: Sales of Cigars
For each brand family of cigars that are...
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AG NPM-LC updated 3.1.23.pdf
State of Illinois
Non-Participating Manufacturer
Certification of Little Cigar/Cigarette
NPM-LC
p. 1 of 2
Part 1: Manufacturer Identification
Company Name LY:2022
Part 2: Sales of Cigars
For each brand family of cigars that are...
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AG NPM-LC updated 1.24.2025.pdf
State of Illinois
Non-Participating Manufacturer
Certification of Little Cigar/Cigarette
NPM-LC
p. 1 of 2
Part 1: Manufacturer Identification
Company Name LY:2024
Part 2: Sales of Cigars
For each brand family of cigars that are...
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AG NPM-F LY2024 updated 1.24.2025.pdf
State of Illinois
Foreign Non-Participating Manufacturer
Certification of Additional Information
NPM-F
p. 1 of 2
Part 1: Liability Year and Type of Certification
☐ 2024 ☐ Other ☐ Initial ☐ Annual ☐ Supplemental...
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AG NPM-F LY2023 updated 3.1.2024.pdf
State of Illinois
Foreign Non-Participating Manufacturer
Certification of Additional Information
NPM-F
p. 1 of 1
Part 1: Liability Year and Type of Certification
☐ 2023 ☐ Other ☐ Initial ☐ Annual ☐ Supplemental...