Fill Your Arkansas Atc R4 Form Fill Out Form Online

Fill Your Arkansas Atc R4 Form

The Arkansas Tobacco Control R4 form is a crucial document that outlines the responsibilities of employees working in establishments that sell tobacco products. It ensures that employees understand the laws regarding the sale of tobacco to minors and helps maintain compliance with state regulations. By signing this form, employees acknowledge their commitment to follow these important guidelines.

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Dos and Don'ts

When filling out the Arkansas ATC R4 form, it’s important to follow certain guidelines to ensure accuracy and compliance. Here are four things you should and shouldn't do:

  • Do ensure that every employee initials each section of the form.
  • Do keep the completed form on file at the store for easy access by employees.
  • Don't sell tobacco products to anyone under 18 years of age.
  • Don't allow any sales of single cigarettes or less than a full pack.

Following these guidelines will help maintain compliance with Arkansas law and promote responsible tobacco sales practices.

Important Details about Arkansas Atc R4

What is the Arkansas ATC R4 form?

The Arkansas ATC R4 form, also known as the Tobacco Server Awareness Form, is a document that employees at tobacco-selling establishments in Arkansas must complete. This form ensures that employees understand their responsibilities and the legal requirements surrounding the sale of tobacco products, particularly regarding age restrictions.

Who needs to fill out the ATC R4 form?

Every employee who works in a store that sells tobacco products is required to fill out the ATC R4 form. This includes cashiers and anyone involved in the sale of tobacco, ensuring they are aware of the laws and regulations regarding tobacco sales.

What are the key responsibilities outlined in the form?

The form outlines several important responsibilities, including:

  • Not selling tobacco products to anyone under 18 years of age.
  • Not selling tobacco products to individuals 18 years or older if they are known to be purchasing for someone under 18.
  • Not selling single cigarettes or any quantity less than a full pack.

Why is it important to keep the ATC R4 form on file?

Keeping the ATC R4 form on file is crucial for compliance with Arkansas law. It serves as proof that employees have been trained and are aware of their responsibilities. Additionally, it must be accessible for inspection by Arkansas Tobacco Control officials.

What are the consequences of violating the regulations outlined in the form?

Violating the regulations can lead to serious consequences. Employees may face criminal charges for selling tobacco products to minors, which can result in fines of up to $100 per violation, in addition to local court costs.

How often should employees sign the ATC R4 form?

Employees must sign the ATC R4 form upon their employment and before they begin selling any tobacco products. It is also advisable to review and re-sign the form periodically, especially if there are updates to the regulations or store policies.

What should be done if an employee is found in violation of the law?

If an employee is found to have violated the law, the store owner or manager should take appropriate action, which may include retraining the employee, disciplinary measures, or even termination, depending on the severity of the violation.

Can employers contact Arkansas Tobacco Control regarding employee violations?

Yes, by signing the ATC R4 form, employees consent to their employers contacting Arkansas Tobacco Control to check for any citations related to violations of tobacco sales laws. This helps maintain compliance and accountability within the store.

How can I obtain the ATC R4 form?

The ATC R4 form can be obtained directly from the Arkansas Tobacco Control website or by contacting their office. The contact details are as follows:

  • Address: Arkansas Tobacco Control, 101 E. Capitol Ave., Suite 401, Little Rock, AR 72201
  • Phone: 501-682-9756
  • Fax: 501-682-9760
  • Website: www.atc.ar.gov

Example - Arkansas Atc R4 Form

 

DFA - ARKANSAS TOBACCO CONTROL

State of Arkansas

101 E. Capitol Ave., Suite 401

Little Rock, AR 72201

Department of Finance

Phone: (501)

682-9756

 

And Administration

Fax: (501)

682-9760

https://www.atc.arkansas.gov

TOBACCO AND VAPOR SERVER AWARENESS FORM

Upon employment, all employees must initial each section, sign, and date this document before selling any tobacco, vapor, alternative nicotine, or e-liquid products. This form is to be kept on file at the store, be accessible to any clerk or employee present, and be available at all times for inspection by any employee of Arkansas Tobacco Control.

As an employee of a permitted outlet, I understand that there are certain things I am prohibited from doing and certain actions that I cannot allow to occur in the outlet. In accordance with Arkansas law and the rules of Arkansas Tobacco Control, I have read, initialed and acknowledged the following:

(Please initial below)

 

 

I will not sell cigarettes, tobacco products, vapor products, alternative nicotine products or e-liquid products

 

 

to anyone 21 years of age or older when I know the products will be provided to a person or persons under the

 

 

age of 21.

_______

 

I understand that cigarettes or tobacco products” includes any substance that contains tobacco, including

 

 

but not limited to, cigarettes, cigars, smokeless tobacco, loose tobacco, hookah tobacco, shisha, and cigarette

 

 

papers.

 

 

I will not sell single cigarettes or any number of cigarettes less than a full pack (20 or 25 cigarettes packaged

 

 

together constitutes a pack) and I understand it is against the law to do so.

________

I understand that sales to anyone under the age of 21 can result in criminal charges being filed against me. I

 

 

understand that as a clerk, if I am found guilty of a violation of A.C.A. § 5-27- 227, I shall be subject to a fine up to

 

 

$100 per violation, plus local court costs.

 

 

I understand that this store may undergo inspection at any time to assess its compliance with the state law

 

 

regarding the sale of cigarettes, tobacco products, vapor products, alternative nicotine products or

 

 

e-liquid products to a minor under the age of 21.

I understand it is illegal to reuse or refill tobacco boxes with cigars, little cigars, cigarillos or any other tobacco product. Any person doing this can be charged with a Class D Felony.

By signing below, I hereby certify that I have read and fully understand the above statements. I agree to always follow state law and not to sell cigarettes, tobacco, vapor, alternative nicotine, or e-liquid products to minors. I further consent to allowing any current or potential employer to contact Arkansas Tobacco Control to determine if I have received any citations for violations of Title 5, Chapter 27 of the Arkansas Code.

 

Employee Signature

 

 

Date Signed

 

 

 

 

 

 

 

 

Printed Name of Employee

 

 

Date Entered Employment

 

 

 

 

 

 

Signature of Owner, Manager or Supervisor

 

Date Signed

FORM ATC R-4 02/2020)

(All blank lines on this form must contain information)