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AG NPM-F LY2023 updated 3.1.2024.pdf
Certification of Additional Information
NPM-F
p. 1 of 1
Part 1: Liability Year and Type of Certification
☐ 2023 ☐ Other ☐ Initial ☐ Annual ☐ Supplemental
Part 2: Manufacturer Identification
Company Name:
Part 3:...
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AG NPM-F LY2022 updated 3.1.2023.pdf
Certification of Additional Information
NPM-F
p. 1 of 1
Part 1: Liability Year and Type of Certification
☐ 2022 ☐ Other ☐ Initial ☐ Annual ☐ Supplemental
Part 2: Manufacturer Identification
Company Name:
Part 3:...
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AG NPM-F LY2021 updated 3.3.22.pdf
Certification of Additional Information
NPM-F
p. 1 of 1
Part 1: Liability Year and Type of Certification
☐ 2021 ☐ Other ☐ Initial ☐ Annual ☐ Supplemental
Part 2: Manufacturer Identification
Company Name:
Part 3:...
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AG NPM-3 LY2022 updated 3.1.2023.pdf
State of Illinois
Non-Participating Manufacturer
Certification of Additional Information
NPM-3
p. 1 of 5
Part 1: Liability Year and Type of Certification
Liability Year for this Certification: Complete a separate form for...
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AG NPM-3 LY2021 updated 3.3.22.pdf
State of Illinois
Non-Participating Manufacturer
Certification of Additional Information
NPM-3
p. 1 of 5
Part 1: Liability Year and Type of Certification
Liability Year for this Certification: Complete a separate form for...
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AG NPM-3 LY 2024 updated 3.10.2025.pdf
State of Illinois
Non-Participating Manufacturer
Certification of Additional Information
NPM-3
p. 1 of 6
Part 1: Liability Year and Type of Certification
Liability Year for this Certification: Complete a separate form for...
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AG NPM-3 LY 2024 updated 1.24.2025.pdf
State of Illinois
Non-Participating Manufacturer
Certification of Additional Information
NPM-3
p. 1 of 5
Part 1: Liability Year and Type of Certification
Liability Year for this Certification: Complete a separate form for...
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AG NPM-3 LY 2023 updated 6.27.23.pdf
State of Illinois
Non-Participating Manufacturer
Certification of Additional Information
NPM-3
p. 1 of 5
Part 1: Liability Year and Type of Certification
Liability Year for this Certification: Complete a separate form for...
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AG NPM-2 LY2024 updated 1.24.2025.pdf
(check one) ☐ 2024 ☐ Other: ______
Type of Certification: (check one) ☐ Initial ☐ Annual ☐ Supplemental
Part 2: Manufacturer Identification
Company Name
Mailing Address
City State Zip Code Country
Phone Fax FEIN
Part 3: Manufacturer Status...
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AG NPM-2 LY2023 updated 3.1.24.pdf
(check one) ☐ 2023 ☐ Other: ______
Type of Certification: (check one) ☐ Initial ☐ Annual ☐ Supplemental
Part 2: Manufacturer Identification
Company Name
Mailing Address
City State Zip Code Country
Phone Fax FEIN
Part 3: Manufacturer Status...
-
AG NPM-2 LY2022 updated 3.1.23.pdf
(check one) ☐ 2022 ☐ Other: ______
Type of Certification: (check one) ☐ Initial ☐ Annual ☐ Supplemental
Part 2: Manufacturer Identification
Company Name
Mailing Address
City State Zip Code Country
Phone Fax FEIN
Part 3: Manufacturer Status...
-
AG NPM-2 LY2021 updated 3.2.22.pdf
(check one) ☐ 2021 ☐ Other: ______
Type of Certification: (check one) ☐ Initial ☐ Annual ☐ Supplemental
Part 2: Manufacturer Identification
Company Name
Mailing Address
City State Zip Code Country
Phone Fax FEIN
Part 3: Manufacturer Status...
-
AG NPM-1 LY 2024 updated 1.24.2025 with directory edit.pdf
Type of Certification: (check one) Initial Annual Supplemental
Part 2: Manufacturer Identification
Company Name FEIN
Mailing Address
City State Zip Code Country
Phone Fax Web Address
Name and title of person completing this form
Part 3:...
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AG NPM-1 LY 2023 updated 3.1.24.pdf
Type of Certification: (check one) Initial Annual Supplemental
Part 2: Manufacturer Identification
Company Name FEIN
Mailing Address
City State Zip Code Country
Phone Fax Web Address
Name and title of person completing this form
Part 3:...
-
AG NPM-1 LY 2022 updated 3.1.23.pdf
Type of Certification: (check one) Initial Annual Supplemental
Part 2: Manufacturer Identification
Company Name FEIN
Mailing Address
City State Zip Code Country
Phone Fax Web Address
Name and title of person completing this form
Part 3:...
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AG NPM-1 LY 2021 updated 3.2.22.pdf
Type of Certification: (check one) Initial Annual Supplemental
Part 2: Manufacturer Identification
Company Name FEIN
Mailing Address
City State Zip Code Country
Phone Fax Web Address
Name and title of person completing this form
Part 3:...
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AG NPM-1 Brands Addendum updated 3.2.22.pdf
State of Illinois Certification of
Non-Participating Manufacturer
NPM-1
Brands
Addendum
Manufacturer Identification
Company Name Brands Addendum Page ____ of ____
Part 3: Brand Family Certification (Attach addendum pages to NPM-...
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AG NPM-1 Brands Addendum updated 3.1.24.pdf
State of Illinois Certification of
Non-Participating Manufacturer
NPM-1
Brands
Addendum
Manufacturer Identification
Company Name Brands Addendum Page ____ of ____
Part 3: Brand Family Certification (Attach addendum pages to NPM-...
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AG NPM-1 Brands Addendum updated 3.1.23.pdf
State of Illinois Certification of
Non-Participating Manufacturer
NPM-1
Brands
Addendum
Manufacturer Identification
Company Name Brands Addendum Page ____ of ____
Part 3: Brand Family Certification (Attach addendum pages to NPM-...
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AG NPM-1 Brands Addendum updated 1.24.2025.pdf
State of Illinois Certification of
Non-Participating Manufacturer
NPM-1
Brands
Addendum
Manufacturer Identification
Company Name Brands Addendum Page ____ of ____
Part 3: Brand Family Certification (Attach addendum pages to NPM-...