application for certification/recertification of fire safe...

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DEPARTMENT OF PUBLIC SAFETY AND CORRECTIONS Public Safety Services Bobby Jindal Governor H. Butch Browning State Fire Marshal Application for Certification/Recertification of Fire Safe Compliant Cigarettes Type of Certification: New Company Supplemental Recertification Manufacturer Information: Company Name: Address: State: Zip Code: Country: City: Contact Name: Fax Number: Phone Number: Web Address: Contact E-Mail: Brand Information: In the space provided fill in all information that is asked for. If any part is left blank this will delay the certification of the brand. Brand (Name on Package) Style (Light, Ultra Light, etc.) Length (mm) Circumference (mm) Flavor (Menthol, Non, Etc.) Filter/Non-Filter Package (Box Type) Date:

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DEPARTMENT OF PUBLIC SAFETY AND CORRECTIONS

Public Safety Services

Bobby Jindal

GovernorH. Butch Browning State Fire Marshal

Application for Certification/Recertification of Fire Safe Compliant Cigarettes

Type of Certification:

New Company Supplemental Recertification

Manufacturer Information:

Company Name:

Address:

State: Zip Code: Country:

City:

Contact Name:

Fax Number:Phone Number: Web Address:

Contact E-Mail:

Brand Information:

In the space provided fill in all information that is asked for. If any part is left blank this will delay the certification of the brand.

Brand (Name on Package)

Style (Light, Ultra Light, etc.)

Length (mm)

Circumference (mm)

Flavor (Menthol, Non, Etc.)

Filter/Non-Filter Package (Box Type)

Date:

Brand (Name on Package)

Style (Light, Ultra Light, Etc.)

Length (mm)

Circumference (mm)

Flavor (Menthol, Non, Etc)

Filter/Non-Filter Package (Box Type)

Checklist of Items to be included for Fire Safe Certification/Recertification

A Check, Money Order, or Cashier's Check for $250.00 made out to the Office of State Fire Marshal

A Letter stating that each cigarette listed has been tested in accordance with and that each cigarette listed meets the performance standards set forth in R.S. 40:1628

The pages provided with all information filled in.

Testing certificate for each cigarette listed. The testing must be done in accordance with ASTM E2187-04 The testing laboratory must be accredited pursuant to standard ISO/IEC 17025

Examples of all packaging to verify FSC markings. This can be actual packaging or digital copies of actual packaging.

If you have any questions, please contact

Cigarette Fire Safety and Firefighter Protection Act 8181 Independence Blvd.

Baton Rouge, LA 70806 225-925-4911

[email protected]

CGonthier
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Cigarette Fire Safety and Firefighter Protection Act 8181 Independence Blvd. Baton Rouge, LA 70806 225-925-4911 [email protected]