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HomeMy WebLinkAboutDollar General Store #20417 - 12/31/2021Town of Mansfield - Board of Health re i PERMIT NUMBER: Town of Mansfield 6 Park Row Mansfield, MA 02048 ---- cation for the Sale of Tobacco Products I hereby make application for a permit to sell tobacco products in compliance with the Board of Health Regulation Affecting Smoking and the Sale, Vending and Distribution of Tobacco. By signing this application, I declare that I have read the regulation and am responsible for tobacco product sales regarding federal, state and local laws. This permit expires on December 31st of each year. Violation of this Regulation may result in fines, suspension or revocation of this permit. NAME OF BUSINESS: Dollar General Store# 20417 LOCATION OF SALE OF TOBACCO PRODUCTS: 650 Copeland Dr. Mansfield, MA 02048 TELEPHONE AT LOCATION: 508-964-2370 OWNER OF BUSINESS: - __DG Refail,__LLC ADDRESS OF OWNER: Attn: Tax Dept-100 Mission Ridge, Goodlettsville, TN. 37072 TELEPHONE OF OWNER: 615-855-4000 FAX NUMBER: 877-364-4130 If a corporation or partnership, give name, title, and home address of officers or partner, see attached Briefly describe your tobacco and nicotine delivery product sales training. Attach employee training documentation _ )qArll. Provide a copy of current Department of Revenue CT-3T Retail Excise Unit License. FEE: 60D CT-3T NUMBER: attached FEDERAL ID/SS NUMBER: 36-4577242 SIGNATURE: x € & 1 j DATE: A check mark signifies your understanding and agreement. 1 understand and agree that: ❑i It is against the law to sell any tobacco product and/or nicotine delivery product (e.g. e-cigarettes) to anyone less than 21 years of age, regardless of how old the person looks. Dr Anyone selling tobacco products and/or nicotine delivery products must conclusively establish the customer's age as over 21 years old, by means of government -issued photographic ID. LY Anyone selling tobacco products and/or nicotine delivery products must check and verify official government photo ID for anyone less than 27 years of age. EY 1 must consent to unannounced, periodic inspections and compliance checks of the permitted retail establishment. ET Flavored tobacco products and vape products (including mint, menthol and wintergreen) can only be sold in licensed smoking bars, for onsite consumption only. D Unflavored E-cigarettes with nicotine content over 35 mg/per ml can only be sold in adult -only retail tobacco stores and licensed smoking bars. EX Flavored e-cigarettes with any strength of nicotine content can only be sold in licensed smoking bars, for onsite consumption only. DSelf-service tobacco product and/or nicotine delivery product displays from which the customer may select products are prohibited. El The sale of single or loose cigarettes or cigarettes in packages of fewer than 20 cigarettes is prohibited. G I may not distribute any free samples of tobacco products or nicotine delivery products (e.g. e-cigarettes) and I may not accept any means, instruments or devices that allow for the redemption of tobacco products for free or cigarettes at a price below the minimum retail price determined by the Massachusetts Department of Revenue. Tobacco vending machines are prohibited. G Non-residential Roll -Your -Own machines are prohibited. C' Blunt wraps are prohibited. G Penalties for violation of the regulation include monetary fines and/or suspension of this permit for seven or thirty days. D I may not allow any employee to sell tobacco products or nicotine delivery products (e.g. e-cigarettes) until such employee reads this regulation, state and federal laws regarding the sale of tobacco and signs a statement, a copy of which will be placed on file, that he/she has read the regulation and applicable state laws. I must prominently display a copy of the "Permit to Sell Tobacco and Nicotine Delivery Devices". ,z I must provide the Board of Health with proof of a current "Cigarette Retailers License" from the Massachusetts Department of Revenue (DOR) and my DOR business permit (Attach a copy of each permit/license). ' I must display Department of Public Health signs stating, "Sale of tobacco to Minors is prohibited". I must display signs provided by the Board of Health that discloses referral information about cessation. If I sell nicotine delivery devices (e.g. e-cigarettes) I must display signs stating that sale of nicotine delivery devices to anyone below the minimum legal sales age is prohibited and that the used of e-cigarettes at indoor establishments is prohibited by local law. I have received, read and understand the Board of Health regulation "Regulation Affecting Smoking and the Sale, Vending, and Distribution of Tobacco and Nicotine Delivery Products" and agree to abide by it. Signature i , Print Name �=�� v = Date E ii,ifl. t 7!� �5nclrUrF Commonwealth of Massachusetts Letter 1D: L0657974848 yct Deportment of Revenue Notice Date: September 29, 2020 Geoffrey E. Snyder, Commissioner Account ID: COL-10527826-005� �FTT OFF mess.gov/dor RETAILER LICENSE FOR SALE OF CIGARETTES L O ct I r Ip[191I11Its] III Jill 1111mh111" ll,[11'g111'111911111[Fir, TAX DEPT-SALES TAX DO RETAIL LLC DOLLAR GENERAL STORES 100 MISSION REG GOODLETTSVILLETN 37072-2I71 Attached below is your Retailer License for Sale of Cigarettes (Form CT-3). Cut along the dotted line and display at your business location. At any time, you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re -print a copy of this license. If you have any questions about your license, call us at (617) 887-6367 or toll -free in Massachusetts at (800) 392-6089, Monday through Friday, 8:30 a.m. to 4:30 p.m. DETACH HERE ��SSACHusFTJ. MASSACHUSETTS DEPARTMENT OF REVENUE Form CT-3 Retailer License for Sale of Cigarettes ?TC>ENro4 This license must be posted and visible at all times. The sale of tobacco products to anyone under 18 years of age is prohibited. DG RETAIL LLC Account ID: CGL-10527826-005 DOLLAR GENERAL STORE #20417 Location ID: 10527826-0180 65 COPELAND DR License Number: 385161216 MANSFIELD MA 02048-1220 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell at retail at the address shown above. This license is non -transferable and may be suspended or revolted for failure to comply with state laws and regulations. Effective Date: October 1, 2020 Expiration Date: September 30, 2022 S�crt(� Co nnonwealth of Massachusetts Or O Later ID: LO 137514560 Department of Revenue Notice Date: Octobcr 7, 2020 Geoffrey E. Snyder, Commissioner Account ID: CRL-10527826-033 'd�FA7 ova mass.gov/dor RETAILER LICENSE FOR SALE OF CIGARS AND SMOKING TOBACCO 111111l'lll"'IIII'1'11III11111111111111r"1II'llll�lll'�II�1�'� TAX DEPT-SALES TAX DG RETAIL LLC DOLLAR GENERAL STORES 100 MISSION RDG GOODLETTSVILLE TN 37072-2171 Attached below is your Retailer License for Sale of Cigars and Smoking Tobacco (Form CT-3T). Cut along the dotted line and display at your business location. At any time, you can log into your MassTaxCotmect account at niass.gov/masstaxconnect to view and re -print a copy of this license. If you have any questions about your license, call us at (617) 887-6367 or toll -free in Massachusetts at (800) 392-6089, Monday through Friday, 8:30 a.m. to 4:30 p.m. DETACH HERE c5ciiusF MASSACHUSETTS DEPARTMENT OF REVENUE Form CT-3T Retailer License for Sale of Cigars and Smoking Tobacco � z This license must be posted and visible at all times. The sale of tobacco products to anyone colder 18 years of age is prohibited. DG RETAIL LLC Account Ill: CRL-10527826-033 DOLLAR GENERAL STORE #20417 Location ID: 10527826-0181 65 COPELAND DR License Number: 1759074304 MANSFIELD MA 02048-1220 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell at retail at the address shown above. This license is non -transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date: October 7, 2020 Expiration Date: September 30, 2022 DG RETAIL, LLC — a Tennessee limited liability company Officer Listing Jason Reiser Chief Merchandising Officer and Secretary Larry Gatta Senior Vice President, General Merchandise Manager Policy Certain designated Dollar General stores sell tobacco products. By law, the sale of tobacco products is age -restricted in every state. Dollar General is committed to complying with all applicable state and local laws and license requirements regarding the sale of tobacco products. Product Storage • Tobacco products must be merchandised and properly secured only in designated areas. The Service Center is the designated area for Dollar General Market stores. A freestanding cabinet fixture will be the designated area for traditional Dollar General stores. All overstock merchandise for traditional stores must be locked in the cigarette cabinet fixture, the locked register under cabinet, or secured in the store office under CCTV. In Dollar General Market stores, sales of tobacco products are restricted to the Service Center. Only the employee assigned to the Service Center and/or the Store Manager (or key carrier as delegated by the Store Manager) may retrieve tobacco products for purchase. All tobacco product transactions must be completed at the Service Center register. If the Service Center is not staffed for any reason, the cigarette cabinet fixture must be locked. • Each cigarette cabinet fixture is equipped with locking doors and will have a designated set of keys. The Store Manager must ensure that at least one key is secured in a deposit bag inside the store safe. The other key must be kept at the register area and may only be used by store employees conducting a sale of tobacco products. The cigarette cabinet fixture must be locked after the completion of each sales transaction. It is never permissible to leave the key in the lock of the cabinet fixture door. At the end of the day, the key must be secured in the store safe with the spare tills. • Due to specific vendor requirements and legal regulations, changes are not permitted to any signage or merchandising related to the tobacco products planogram. Do not make any changes to the planogram without authorization from the Store Support Center. Changes are also not allowed to the cigarette merchandising fixture without approval from the Store Support Center. A clear line -of -sight must be maintained from the registers to the fixture at all times. Do not place merchandise between the cigarette merchandising fixture and the registers. CONTINUED ON NEXT PAGE 6 Questions? Call the Employee Response Center (ERC) at 1-888-237-4114. Sale of Product • Prior to completing the sale of tobacco products, employees must check every customer for valid identification CID") and establish the customer's age. The following photo identification may be accepted as proof of age: l) valid drivers license from any state; 2) valid military identification card; 3) a valid state issued (non driver) identification card of any state; and 4) a valid identification card issued by the federal government [e.g., passport, permanent resident card ("green card")]. Valid identification must contain the date of birth and a photograph. An expired ID is not valid and may not be accepted. Identification must be checked at the time of purchase for every sale, even if the customer's ID has been checked on previous occasions. Employees should read the birth date on the customer's ID as they enter the birth date in the register, and return it to the customer after entering the birth date. • Under no circumstances may a customer that is underage purchase tobacco products at a Dollar General store. If the Company determines that an employee has sold, given, or allowed any underage person to purchase tobacco products on Company premises he or she is subject to disciplinary action up to and including termination, even for the first offense. • An employee must not sell tobacco products to anyone who the employee knows or believes is buying tobacco products on behalf of an underage person, even if the person attempting to make the purchase is of legal age. — Tobacco products must be kept at the register until the purchase has been completed. Employee Purchases of Tobacco Products Employee purchases of tobacco products must meet all Dollar General policies as outlined in the Employee Purchases (SOP 81) policy and procedures, including taping the receipt to the tobacco item purchased. For further details, refer to the Employee Purchases (SOP 81) policy and procedures. Employees should be prepared to present an applicable proof of purchase when in possession of tobacco products sold at Dollar General during the Employee Presentation process. For further details, refer to the Employee Presentation (SOP 199) policy and procedures. CONTINUED ON NEXT PAGE Questions? Call the Employee Response Center (ERC) at 1-888-237-4114. Accountability • Employees must meet the state minimum age requirements to sell or scan tobacco products. Otherwise, the Store Manager (or key carrier as delegated by the Store Manager) must be called to scan the item and check ID. • Store employees are not permitted to accept gifts of any type or free merchandise (including any samples) from any tobacco products vendor. This includes, but is not limited to, expired or saleable merchandise. • In the event that a tobacco product sales violation occurs, the Store Manager must promptly notify the District Manager. Immediately Scan and Send all documentation received to Violations — Alcohol and Tobacco. Store Managers should also notify the District Manager upon receipt of any notice of license suspension or revocation. • For more information regarding "scan and send," refer to the Scan and Send (SOP 239) policy and procedures. • If the Company determines an employee is not inspecting ID for tobacco products sales, accepting ID that is clearly not valid or in one of the four categories of acceptable ID, or is entering incorrect birth dates into the registers, he or she is subject to disciplinary action up to and including termination, even for the first offense. • Store Manager and employees must cooperate with all regulatory visits. For more information, refer to the Regulatory Visits (SOP 128) policy and procedures. • Certain states may impose criminal and/or civil penalties on the store employee personally for selling tobacco products to persons under the legal age limit. Certain states, cities, and counties may have additional rules regarding the sale of Tobacco Products. Refer to the Tobacco Set Guide and/or the Store Support Center for guidance. Procedures Point of Sale 1. When checking ID, complete the following steps: • Always examine the date of birth. Make sure the customer is old enough to purchase tobacco products on day of purchase. • Employees should read the birth date on the customers ID as they enter the birth date in the register, and return it to the customer after entering the birth date. • Verify the photo on the ID is the customer presenting the ID. CONTINUED ON NEXT PAGE Questions? Call the Employee Response Center (ERC) at 1-888-237-4114. • Check the expiration date. Expired IDs are not valid. • Look for misaligned birth and expiration dates, erasures, smudges, glue lines, blurry or bumpy surfaces, and other signs of tampering. • Look for special ID features such as a holograms, state seals, and logos. • Both the front and back of the ID should be checked for authenticity. • If you are unsure about the validity of the ID, ask about basic information on the ID, such as birth date and address. • Ask for a second form of ID, as needed. If you are unsure whether the ID is valid or correct, do not complete the purchase. It is much better to say "no" than to risk a violation. • Always maintain a customer service attitude when refusing tobacco product sales. Stay calm. Remember, it is not personal; it is the law. A few carefully chosen words can make the difference in how customers react in these situations. An example response would be: — "I'm sorry, I am unable to sell you any tobacco products today. Our store has to follow state law, and I can lose my job" • If the customer becomes confrontational or threatening, do the following: 1) ask him or her to leave the store, 2) request assistance from the Store Manager (or key carrier as delegated by the Store Manager), and/or 3) contact law enforcement. • Customer refunds/exchanges of tobacco products are not allowed under any circumstances. Receiving and Stocking — Tobacco Products 1. Check in all tobacco products under CCTV coverage using the HHT For more information on this process, refer to the Direct Store Delivery (DSD) and Drop Ship (DS) Receiving (SOP 26) policy and procedures. 2. Prior to signing for the delivery, the Store Manager (or manager on duty, as delegated by the Store Manager) should validate that the number of boxes received agrees with the number of boxes shipped. 3. Receive all tobacco products through the HHT by following the Direct Store Delivery (DSD) and Drop Ship (DS) Receiving (SOP 26) policy and procedures. 4. Only stock tobacco products in designated cigarette cabinet fixtures. Any overstock must be secured in the designated cabinet fixture or store office. Locking overstock in the store office only applies for traditional stores with over -the -register cabinet fixtures. S. All shipments will be delivered via FedEx. The Store Manager (or manager on duty, as delegated by the Store Manager) should receive and process the complete cigarette delivery immediately, stocking the product in the designated secure fixture. CONTINUED ON NEXT PAGE 1 Questions? Call the Employee Response Center (ERC) at 1-888-237-4114. 6. The Store Manager (or manager on duty, as delegated by the Store Manager) must log all shortages on the Receiving Log and contact the vendor by phone to report the shortages. Discrepancies must be reported to the vendor within 24 hours. The vendor will provide the store with an authorization number to verify that credit for the shortage is issued and make arrangements for the store to receive the shorted/mis-shipped product on the next delivery. 7 The physical transport of tobacco products from store to store by store employees or field management is not permitted. Tobacco products should not be transferred from store to store or sent to a distribution center. 8. Tobacco products kept at the register and all overstock products must be secured in a locking fixture. Only Dollar General Employees may carry the case keys and unlock the case. 9. Tax Stamps — Each state has its own unique tax stamp that is applied by the vendor prior to delivery. Cigarettes must be sold within the state matching the state tax stamp. Also, in some states, tax stamps may also be required by the county or the city in which they are sold. Refer to the Tobacco Set Guide found on STOREnet for specific requirements. The Store Manager (or key carrier, as delegated by the Store Manager) is responsible for verifying that all cigarette packs are stamped with the appropriate tax stamp. Any cigarette packs found with no state stamp or the wrong state stamp should not be sold. The Store Manager (or key carrier, as delegated by the Store Manager) should contact the vendor immediately to arrange return of product with no stamp or incorrect stamp (See Inventory Management section below). Cycle Counting of Tobacco Tobacco out of stocks should be scanned the day after the weekly delivery. — Check all overstock locations before scanning any out of stocks — Scan each out of stock using the HHT. If the quantity on -hand does not match the currently quantity in the store, immediately correct the discrepancy. — If the store notices a large quantity of a specific tobacco UPC, scan the UPC with the HHT, and verify the quantity on -hand matches the quantity in the store. Make adjustments as needed to correct any discrepancies. Inventory Management Follow these procedures when requesting credit for merchandise shipped to your store MISPICKED MERCHANDISE • Mis-picked or mis-stamped items from a delivery may be returned via FedEx. A FedEx return shipping label will be included in the next delivery. Contact the vendor within 24 hours of delivery to arrange a pick up. CONTINUED ON NEXT PAGE 1 Questions? Call the Employee Response Center (ERC) at 1-888-237-4114. For example: A store that receives one delivery per week will box up the return, at the time of the following delivery, the Store Manager (or manager on duty, as delegated by the Store Manager) will apply the FedEx shipping label and give the package to the FedEx driver. DAMAGED AND OUTDATED MERCHANDISE • Full case, partial case or unit damaged, outdated and/or close dated items discovered at time of delivery can be processed by contacting the vendor. Credit for mis-stamped inventory identified after the carton has been opened can be processed by contacting the vendor. Mis-stamped request for credit does not need to meet the 24 hours from delivery time threshold. REQUEST TO RETURN MERCHANDISE • If merchandise needs to be returned after the delivery, call the vendor within 24 hours of delivery and make a "Request to Return Merchandise' using RESPOND on STOREnet. • Items requested for return may be returned via FedEx. A FedEx return shipping label will be included in the next delivery. Contact the vendor within 24 hours of delivery to arrange a pick up. For example: A store that receives one delivery per week will box up the return, at the time of the following delivery, the Store Manager (or manager on duty, as delegated by the Store Manager) will apply the FedEx shipping label and give the package to the FedEx driver. • All returns other than mispicks, billing errors, outdated at time of delivery, or damage will incur a $5.00 per carton restocking charge. IMPORTANT REMINDERS Requests to research credits written must be initiated within 21 days of the credit memo date. • Merchandise returned to the vendor outside of the parameters of the credit policy are subject to denial. Credit forms must be signed and dated by authorized store personnel. • Dollar General stores may only return product using a pre -approved credit memo written by the vendors customer service representative. • The Dollar General customer number, invoice number (if available) FedEx tracking number, item number, quantity by item, and the delivery date must be given on all requests for credit. The shipping expense for product damaged before or during shipment, outdated product noted at time of receipt, mis-stamped product, and product mispicks will be the responsibility of the vendor. Questions? Call the EmDlovee Response Center (ERC) at 1-888-237-4114. Age -Restricted Products Policy & Procedures: Tobacco LOCATION Every Employee at this location has the legal and moral responsib!lity.to control the sale and distribution of age -restricted items to ensure these items do not get sold to minors!! TOBACCO PRODUCT SALES POLICY Objective: That all store Employees follow all laws and procedures of this policy related to the sale of tobacco products including: cigarettes, smokeless tobacco, loose tobacco, pipe tobacco, rolling papers, cigars, e-cigarettes, vape and lighters. The minimum age to purchase tobacco products is twenty one (21) years of age. it is our responsibility as a retailer and members of the community to prevent the sale of tobacco to anyone under the age of twenty one (21). PROCEDURES: 1. This policy will be reviewed with all new Employees before they can operate a cash register and sell tobacco products. 2. All store Employees to take computer based training and successfully pass with 100% prior to starting on a register. This certification to be updated on an annual basis prior to previous year expiration. 3. A valid form of identification will be required for all tobacco purchases regardless of age or frequency of customer visits. Acceptable forms of id are as follows: Valid Massachusetts License Valid Massachusetts state !d Valid US passport Valid Out of State License No expired identification will be accepted. �0lr1I PV1-1 C. Photos must be visually matched to the customer purchasing and licenses scanned into the register. Driver's License is to be scanned into the register system. All other identification from the acceptable list will require manual entry of the date of birth listed on the documentation. 4. If it is suspected that someone is purchasing tobacco for anyone under the age of twenty-one (21) a valid Id will be required from all members of the pa rty. I have read and understand the Mansfield Board of Health Regulations which prohibits the sale of tobacco and nicotine deliveryproducts to anyone under the age of twenty-one (21) years. I also understand that If I fail to follow store policy and local and state laws about the sale of tobacco or nicotine delivery products to any person under the legal age, I could lose my job ocbg fined. - I agree to the following rules about the sale of tobacco products: I will not sell any tobacco products, including cigarettes, cigars, chewing tobacco, bidis, or any other form of tobacco, or any nicotine delivery product to any person under the age of 21. If any person regardless of age attempts to make a tobacco purchase without an acceptable, I will not make the sale. I will not accept a note from an adult giving permission to a person under the age of 21 to buy tobacco products. In turn, management agrees to support my judgment not to make the sale in any of the cases described above. Failure to follow this policy may result in disciplinary action up to and including termm ion. r� JEmoVe Si e Store Ope ignature Date This f6 Ae maintained in your personnel file as a part of your permanent employee record) Photos must be visually matched to the customer purchasing and licenses scanned into the register. Driver's License is to be scanned into the register system. All other identification from the acceptable list will require manual entry of the date of birth listed on the documentation. 4. If it is suspected that someone is purchasing tobacco for anyone under the age of twenty-one (21) a valid Id will be required from all members of the party. I have read and understand the Mansfield Board of Health Regulations which prohibits the sale of tobacco and nicotine delivery products to anyone under the age of twenty-one (21) years. I also understand that if I fail to follow store policy and local and state laws about the sale of tobacco or nicotine delivery products to any person under the legal age, I could lose my job or be fined. I agree to the following rules about the sale of tobacco products: 1 will not sell any tobacco products, including cigarettes, cigars, chewing tobacco, bidis, or any other form of tobacco, or any nicotine delivery product to any person under the age of 21. if any person regardless of age attempts to make a tobacco purchase without an acceptable, I will not make the sale. I will not accept a note from an adult giving permission to a person under the age of 21 to buy tobacco products. In turn, management agrees to support my judgment not to make the sale in any of the cases described above. Failure to follow this policy may result in disciplinary action up to and including urination. z f ployee Sign re Date Store Date !This formlWill P�haintained in your personnel file as a part of your permanent Pmployee rec d) eWs Photos must be visually matched to the customer purchasing and licenses scanned into the register. Driver's License is to be scanned into the register system. All other identification from the acceptable list will require manual entry of the date of birth listed on the documentation. 4. If it is suspected that someone is purchasing tobacco for anyone under the age of twenty-one (21) a valid Id will be required from all members of the pa rty. I have read and understand the Mansfield Board of Health Regulations which prohibits the sale of tobacco and nicotine delivery products to anyone under the age of twenty-one (21) years. I also understand that if I fail to follow store policy and local and state laws about the sale of tobacco or nicotine delivery products to any person under the legal age, I could lose my job or be fined. I agree to the following rules about the sale of tobacco products: I will not sell any tobacco products, Including cigarettes, cigars, chewing tobacco, bidis, or any other form of tobacco, or any nicotine delivery product to any person under the age of 21. If any person regardless of age attempts to make a tobacco purchase without an acceptable, I will not make the sale. I will not accept a note from an adult giving permission to a person under the age of 21 to buy tobacco products. In turn, management agrees to support my judgment not to make the sale in any of the cases described above. Failure to fol w this policy ma result in disciplinary action up to^and including tergtin tio�///lil.-��- Date for Siplat_ure Date (This form will "aintained in your personnel file as a part of your permanent employee record) l{1/ Ct-74 K, < vv ' . �J Photos must be visually matched to the customer purchasing and licenses scanned into the register. Driver's License is to be scanned into the register system. All other identification from the acceptable list will require manual entry of the date of birth listed on the documentation. 4. If it is suspected that someone is purchasing tobacco for anyone under the age of twenty-one (21) a valid Id will be required from all members of the party. I have read and understand the Mansfield Board of Health Regulations which prohibits the sale of tobacco and nicotine deliveryproducts to anyone under the age of twenty-one (21) years. I also understand that if I fall to follow store policy and local and state laws about the sale of tobacco or nicotine delivery products to any person under the legal age, I could lose my job or be fined. I agree to the following rules about the sale of tobacco products: I will not sell any tobacco products, Including cigarettes, cigars, chewing tobacco, bidis, or any other form of tobacco, or any nicotine delivery product to any person under the age of 21. if any person regardless of age attempts to make.a tobacco purchase without an acceptable, I will not make the sale. I will not accept a note from an adult giving permission to a person under the age of 21 to buy tobacco products. In turn, management agrees to support my judgment not to make the sale in any of the cases described above. Failure to follow this policy may result in disciplinary action up to and including be maintained in your personnel file as a part of your permanent record) Photos must be visually matched to the customer purchasing and licenses scanned into the register. Driver's License is to be scanned into the register system. All other identification from the acceptable list will require manual entry of the date of birth listed on the documentation. 4. If it is suspected that someone is purchasing tobacco for anyone under the age of twenty-one (21) a valid Id will be required from all members of the pa rty. i have read and understand the Mansfield Board of Health Regulations which prohibits the sale of tobacco and nicotine delivery products to anyone under the age of twenty-one (21) years. I also understand that if I fail to follow store policy and local and state laws about the sale of tobacco or nicotine delivery products to any person under the legal age, I could lose my job or be fined. I agree to the following rules about the sale of tobacco products: I will not sell any tobacco products, including cigarettes, cigars, chewing tobacco, bidis, or any other form of tobacco, or any nicotine delivery product to any person under the age of 21. If any person regardless of ege attempts to make a tobacco purchase without an acceptable, I will not make the sale. I will not accept a note from an adult giving permission to a person under the age of 21 to buy tobacco products. In turn, management agrees to support my judgment not to make the sale in any of the cases described above. Failure to follow this policy may result in disciplinary action up to and including illation. Store Operator (This form will employee record} 16) lw�_ 0 Date Date ntained in your personnel file as a part of your permanent COv✓T1 it % "�V¢ a r1 . Photos must be visually matched to the customer purchasing and licenses scanned into the register. Driver's License is to be scanned into the register system. All other identification from the acceptable list will require manual entry of the date of birth listed on the documentation. 4. If it is suspected that someone is purchasing tobacco for anyone under the age of twenty-one (21) a valid Id will be required from all members of the party. I have read and understand the Mansfield Board of Health Regulations which prohibits the sale of tobacco and nicotine delivery products to anyone under the age of twenty-one (21) years. I also understand that If I fail to follow store policy and local and state laws about the sale of tobacco or nicotine delivery products to any person under the legal age, I could lose my job or be fined. I agree to the following rules about the sale of tobacco products: I will not sell any tobacco products, Including cigarettes, cigars, chewing tobacco, bidis, or any other form of tobacco, or any nicotine delivery product to any person under the age of 21. if any person regardless of age attempts to make a tobacco purchase without an acceptable, I will not make the sale. 1 will not accept a note from an adult giving permission to a person under the age of 21 to buy tobacco products. In turn, management agrees to support my judgment not to make the sale in any of the cases described above. Failure to follow this policy may result in disciplinary action up to and including term�atio I O E pl ee S' ure Date Store Op to re Date will be maintained in your personnel file as a part of your permanent employee record) Kepi li n � �r�.e2 Photos must be visually matched to the customer purchasing and licenses scanned into the register. Driver's License is to be scanned into the register system. All other identification from the acceptable list will require manual entry of the date of birth listed on the documentation. 4. If it is suspected that someone is purchasing tobacco for anyone under the age of twenty-one (21) a valid Id will be required from all members of the party. I have read and understand the Mansfield Board of Health Regulations which prohibits the sale of tobacco and nicotine delivery products to anyone under the age of twenty-one (21) years. I also understand that if I fail to follow store policy and local and state laws about the sale of tobacco or nicotine delivery products to any person under the legal age, I could lose my job or be fined. I agree to the following rules about the sale of tobacco products: t will not sell any tobacco products, including cigarettes, cigars, chewing tobacco, bidis, or any other form of tobacco, or any nicotine delivery product to any person under the age of 21. If any person regardless of age attempts to make a tobacco purchase without an acceptable, I will not make the sale. I will not accept a note from an adult giving permission to a person under the age of 21 to buy tobacco products. In turn, management agrees to support my judgment not to make the sale in any of the cases described above. Failure to follow this policy may result in disciplinary action up to and including termination. / v� E. I ee Si nature Date Store 0 rator Signatur Date (This form will be maintained in your personnel file as a part of your permanent employee record)