Certificate of Compliance

DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service

Centers for Disease Control
and Prevention (CDC)
Atlanta, GA 30341-3724

<>

CERTIFICATE OF COMPLIANCE

<>
<>
<>
<>
>>City, State, Zip code>>
Dear <>:
This is to inform you that the Office on Smoking and Health is in receipt of the Ingredient Report
submitted on <>, on behalf of <> for the brands of cigarettes for the reporting
year of <>. The submission meets the requirements and is in full compliance with the
Federal Cigarette Labeling and Advertising Act, 15 U.S.C. §1335a(a). I appreciate your

response and anticipate your subsequent submission due by March 31, YYYY. Future
submissions should be addressed as follows:
Mailing Address:
Attn: FCLAA Program Manager
CDC, OSH
Mailstop S107-7
4770 Buford Highway, N.E.
Atlanta, GA 30341-3717

Overnight Delivery:
Attn: FCLAA Program Manager
CDC Warehouse
Mailstop S107-7
3719 North Peachtree Rd., Building 100
Chamblee, GA 30341-2241

Submissions can be sent by facsimile to (770) 488-5759; however, faxed submissions must be
followed up with a mailed original.
If you need additional assistance please contact Ruth L. Hayes (Contractor), (770) 488-5743, or
visit the FCLAA web page, http://www.cdc.gov/tobacco/fclaa.
Sincerely yours,
Deirdre Lawrence Kittner, PhD, MPH
Director
Office on Smoking and Health
National Center for Chronic Disease Prevention &
Health Promotion
Centers for Disease Control & Prevention