When accepting an order for a delivery of an online cigar sale from a buyer, the retailer must obtain the following information from the buyer placing the order:

1. (1) A certification from the buyer documenting that the buyer:

   1. (A) Is of legal age to purchase tobacco products in the State of Arkansas;
   2. (B) Understands that providing false information may be a violation of law; and
   3. (C) Understands that it is a violation of law to purchase cigars for subsequent resale or for delivery to persons who are under the legal age to purchase cigars;
2. (2) The name of the person making the order;
3. (3) The address where delivery is to occur;
4. (4) The phone number of the person making the order;
5. (5) The date of birth for the person making the order; and
6. (6) The payment information.