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U.S. Department of Health and Human Services

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Tobacco Products Forms

Form Date Food and Drug Administration Forms Format Contact Info
3741  05/2014 Registration and Listing for Owners and Operators of Domestic Tobacco Product Establishments (PDF)  (PDF - 898KB) Chris Colburn
301-796-8758
3742  05/2014 Listing of Ingredients in Tobacco Products (PDF)  (PDF - 886KB) Chris Colburn
301-796-8758
3743  05/2014 Tobacco Health Document Submission (PDF)  (PDF - 785KB) Chris Colburn
301-796-8758
3779  07/2014 Tobacco Product Violations Reporting (PDF)  (PDF - 1.2MB) Chris Colburn
301-796-8758
3787a  03/2013 Cigarette Report (PDF)  (PDF - 1.6MB) Chris Colburn
301-796-8758
3787b  05/2014 Smokeless Tobacco Product Report (PDF)  (PDF - 911KB) Chris Colburn
301-796-8758
3787c  05/2014 Roll-Your-Own (RYO) Tobacco Products (PDF)  (PDF - 828KB) Chris Colburn
301-796-8758
3787d  08/2013 Tobacco Product Identification Worksheet (HTML)  (HTM - 0KB) Chris Colburn
301-796-8758
3787e  08/2013 Cigarette Smoke (ISO Regimen) Report Worksheet (HTML)  (HTM - 0KB) Chris Colburn
301-796-8758
3787f  08/2013 Cigarette Smoke Report (Intense Regimen) Worksheet (HTML)  (HTM - 0KB) Chris Colburn
301-796-8758
3787g  08/2013 Cigarette Smoke (Other Regimen) Report Worksheet (HTML)  (HTM - 0KB) Chris Colburn
301-796-8758
3787h  08/2013 Cigarette Filler Report Worksheet (HTML)  (HTM - 0KB) Chris Colburn
301-796-8758
3787i  08/2013 Smokeless Tobacco Product Report Worksheet (HTML)  (HTM - 0KB) Chris Colburn
301-796-8758
3787j  08/2013 Roll-Your-Own Tobacco Product Report Worksheet (HTML)  (HTM - 0KB) Chris Colburn
301-796-8758
3852  07/2014 Report of Tobacco Product Removals Subject to Tax for Tobacco Product User Fee Assessments  (PDF - 665KB) Chris Colburn
301-796-8758
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