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Tobacco International Buyers' Guide & Global Directory 2016 147 A Lockwood Publication • Established 1886 3743 Crescent Street, 2nd Fl., Long Island City, NY 11101 Telephone: +1 347-730-5194 • Fax: +1 347-730-6212 2017 Buyers' Guide & Directory Questionnaire Please return this form by Fax to +1-347-730-6212 Thank you for your help! Or go to: www.tobaccointernational.com/ buyersguide/form.htm CONTACT NAME: (This person will receive an EDITORIAL PROOF for verification/corrections prior to publication) This is a: New Listing Revised Listing COMPANY INFORMATION Company Name Affiliation Address City State Zip Country Phone Fax E-mail Web PERSONNEL INFORMATION Name Title Name Title Name Title Name Title Name Title Name Title BRANCH/PLANT INFORMATION (List as many as desired.) Branch Name Address City State Zip Country Phone Fax E-mail Web Your response to this questionnaire will be published in our annual directory. There is no charge or obligation. Please type or print all information clearly.