Submission of electronic cigaretteand refill containermarket information in accordance with Section 8 of Decree No. 37/2017 Coll., on Electronic Cigarettes and Herbal Products for Smoking

for the period 1 March 2017 to 31 December 2017

Submission made by

The manufacturer (natural or legal person who manufactures a tobacco product or has it designed or manufactured and markets this product under its name or brand):

Name of manufacturer:

Address of manufacturer:

Identification number created by the operator of the Common Entry Gate (EU-CEG) under which products in the EU-CEG are submitted:

The importer (owner of a product related to tobacco products or a person who has the right to dispose of tobacco-related products that have been shipped to the territory of a Member State of the European Union):

Name of importer:

Address of importer:

Identification number created by the operator of the Common Entry Gate (EU-CEG) under which products in the EU-CEG are submitted:

The data below ispresented for:

electronic cigarettes containing nicotine

replacement containers containing nicotine

a) Summary of sales volume information by brand and type of product

  1. Type of product: Electronic cigarette — Disposable:

brand name:[1], product ID:[2], sales volume information:[3]

brand name:1, product ID:2, sales volume information:3

etc.

  1. Type of product: Electronic cigarette — Refillable, device only:

brand name:1, product ID:2, sales volume information:3

brand name:1, product ID:2, sales volume information:3

etc. ...

  1. Type of product: Electronic cigarette — Refillable, placed on the market with one type of e-liquid (fixed combination):

brand name:1, product ID:2, sales volume information:3

brand name:1, product ID:2, sales volume information:3

etc.

  1. Type of product: Electronic cigarette — Rechargeable, device only. Any rechargeable which can also be used as a refillable should be reported under the refillable category:

brand name:1, product ID:2, sales volume information:3

brand name:1, product ID:2, sales volume information:3

etc.

  1. Type of product: Electronic cigarette — Rechargeable, placed on the market with one type ofeliquid (fixed combination). Any rechargeable which can also be used as a refillable should be reported under the refillable category:

brand name:1, product ID:2, sales volume information:3

brand name:1, product ID:2, sales volume information:3

etc.

  1. Type of product: Individual part of electronic cigarette capable of containing e-liquid:

brand name:1, product ID:2, sales volume information:3

brand name:1, product ID:2, sales volume information:3

etc.

  1. Type of product: Kit — Pack containing more than one different e-cigarette device and/or more than one different refill container/cartridge:

brand name:1, product ID:2, sales volume information:3

brand name:1, product ID:2, sales volume information:3

etc.

  1. Type of product: Other:

brand name:1, product ID:2, sales volume information:3

brand name:1, product ID:2, sales volume information:3

etc.

  1. Type of product: Refill container/cartridge containing e-liquid:

brand name:1, product ID:2, sales volume information:3

brand name:1, product ID:2, sales volume information:3

etc.

b) Information about the preferences of different consumer groups, including young people, non-smokers and the main types of current users:[4]

c) Information about the methods of product sales:[5]

(d) Summaries of any market research conducted to identify the information referred to in points (a) to (c):[6]

Page 1 of a total of 2 pages

[1]enter the name of the brand name under which the product is submitted to the EU-CEG

[2]enter theProduct ID under which the product is submitted to the EU-CEG

[3]enter sales volume information

[4]enter available information about preferences; graphs, table representations permitted

[5]enter available information about the methods of sales; graphs, table representations permitted

[6]enter information about the conducted research that led to the obtainment of background information for points (a) to (c)