Tobacco Documents Online

Donnelley Marketing pi} acornpanvof ilfl ThcDun&"6radstrcctCorporanon CouponRedempiion5ervices LORI LLARD CIGARETTES 900 Donnelley Drive, Elm City NC 27822 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 L.ORILLARD 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. FORNER NAME (IF RECENT OWNER CHANGE) PHONE ND. PREA CODE M1N3ER--- 3. STREET ADDRESS (P.O. BOX NOT ACCEPTABLE) 4. CITY, STATE & ZIP CODE 5. NAME OF OWNIDR(S) OR OFFICERS IF CORPORATION 6. HDW LONG IN 7. ARE YOU SUBMITTING - IF YES, GIVE ADDRESS ~ IF YES. CID ~S YES BUSINESS AT COWONS FOR MORE OF ALL STORES ON YOU OWN ALL THIS ADDRESS? THAN ONE STORE? ND REVERSE SIDE. THESE STORES NO 8. HOW WDULD YOU IDENTIFY YOU3 SiDRE9 (CHECK DNE) . _ A. GROCERY STORE _ D. CANDY STORE _ G. CIGAR/TO6ACCO J. OTMER (PLEASE SPECIFY) _ B. DEPARTMENT STORE - E. DRUG STCRE - H. MISC. FOOD STORE _ C. VARIETY STORE _ F. LIQUOR STORE _ I. MISC. GENERAL 9. APPROXIMATE 10. CIGARETTE 11. INTERNAL REVENUE ANNUAL QiOSS LICENSE IDENTIFICATION SALES VOLUME. NUMDER NO. NAME E ADDRESS OF YDIH WHOLESALER 'I CERTIFY THAT THE STORE(S) NAMED ABOVE IS A BONA-FIDE RETAIL ESTABLISHMENT" SiGNATURE DATE 89723272 TfTLE THANK YOU FOR YOUR COOPERATION DATA BASE SUPERVISOR , LORILLARD CCd1PDN REDEMPTION SERVICE _S ~ P-~rl!