Tobacco Documents Online

'ySp.z:_.jy Donnelley Marketing nn acompanyo( ~/L T6c~un&BradStrcctCorporation Coupon Redemption Services LORILLARD CIGARETTES 900 Donnelley Drive, Elm City NC27822 919 236-4061 DEAR RETAILER: IN CHECKING OUR COUPON REDEMPTION RECORDS, WE HAVE FOUND THAT WE ARE HOLDING COUPONS BECAUSE OF AN INCOMPLETE RECORD OF YOUR ESTABLISHMENT. IT IS LORILLARD'S POLICY TO HAVE THE FOLLOWING QUESTIONNAIRE FILLED OUT ONLY ONCE TO ESTABLISH AN ACCOUNT NUMBER FOR YOUR PLACE OF BUSINESS AND HELP US SPEED UP YOUR PAYMENTS. THIS QUESTIONNAIRE HELPS YOU, THE RETAILER, TO RECEIVE YOUR PAYMENTS PROMPTLY AND HELPS BOTH YOU AND LORILLARD MOVE THE EXTRA PRODUCT DUE TO COUPONING PROGRAMS. WE ARE ASKING YOU TO TAKE ONLY A FEW MINUTES TO FILL OUT THIS QUESTIONNAIRE, MAIL IT OUT IN THE ENCLOSED, SELF-ADDRESSED ENVELOPE AND HELP LORILLARD AND YOU ESTABLISH A GOOD WORKING RELATIONSHIP. . STORE NAME 2. FORMER NAME (IF RECENT OWNER CHANGE) PHCNE N0. A3EA CCDE NUFHER 3. STREET ADDRESS (P.D. BOX NOT ACCEPTABLE) 4. CITY, STATE & ZIP CODE S. NAME OF OWNER(S) DR DFFICERS IF CDRPCRATIIXJ 6. HOW LDNG IN T, PRE YOU SUBMITTING ~ IF YES. GIVE ADDRESS F- IF YES DO BUSINESS AT YES COUPONS FOR MORE DF ALL STORES ON , YOU OWN ALL YES -- THIS ADDRESS? _ THAN ONE STDRE? NO REVERSE SIDE. THESE STORES NO 6. HOW WDIJLD YOU IDENTIFY YDI.R STORE? (CHECK DNE) _ A. GROCERY STDRE _ D, CANDY STORE - G. CIGAR/TCfiACCD J. OTHER I (PLEASE SPECIFY) _ B. DEPARTMENT STORE _ E. DRUG STURE _ H. MISC. FOOD STORE _ C. VARIETY STORE - F. LIQUOR STORE - I. MISC. GENERAL 9. APPROXIMATE 10. CIGARETTE 11. INTERNAL REVENUE ANNUAL GROSS LICENSE IDENTIFICATION SALES VDI.UME NLM6ER NO. NAME & ADDRESS OF YOLR WMDLESN-ER "I CERTIFY THAT THE STORE(S) NAMED ABOVE IS A BONA-FIDE RETAIL ESTABLISHMENT" SIGNATI.RE TITLE DATE THANK YOU FOR YOUR COOPERATION (,a , DATA BASE SUPERVISOR ~ LIXtILLARD COUPIXJ REDEMPTION SERVICES GO