Fillable Form 1.: NEW USER MODIFY USER/ DELETE USER (Alcohol and Tobacco tax and Trade Bureau)

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Form 1.: NEW USER MODIFY USER/ DELETE USER (Alcohol and Tobacco tax and Trade Bureau)

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OMB No. 1513-0111 (08/31/2016)
DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
COLAs ONLINE ACCESS REQUEST
Submit this form to the Advertising, Labeling and Formulation Division, TTB, 1310 G Street, NW, Box 12, Suite 400E, Washington, DC 20005
ALFD TRACKING NUMBER
A – ACTION REQUESTED - Please read instructions to check appropriate box
1.
NEW USER MODIFY USER/ DELETE USER REACTIVATE USER
2. IF MODIFYING, DELETING, OR REACTIVATING
THEN PROVIDE EXISTING USER ID, if known
B – USER INFORMATION: Please complete section B with all the required data to establish a user identification record.
3. FIRST NAME
4. MIDDLE
INITIAL
5. LAST NAME
6. SUFFIX (i.e., Jr., Sr., III)
7. LABEL REP ID NUMBER, if any
8. DATE OF
BIRTH
9. MOTHER’S MAIDEN NAME
10. EMPLOY EE TITLE
11. BUSINESS PHONE NUMBER
12. BUSINESS E-MAIL ADDRESS (required)
1
13. BUSINESS FAX NUMBER
14. BUSINESS MAILING ADDRESS OF PERSON REQUESTING ACCESS TO COLAs ONLINE (if
different than 15.)
C – COMPANY INFORMATION: Provide information about the company for which you request to e-file applications
15. NAME AND STREET ADDRESS OF COMPANY AS IT APPEARS ON THE REGISTRY, PERMIT, OR BREWER’S NOTICE
16. REGISTRY, PERMIT, OR BREWER’S NOTICE NUMBER(S) FOR THE ABOVE ADDRESS (Use a separate sheet if necessary. See instructions.)
REQUESTOR’S CERTIFICATION
I hereby attest that the entries on this form are true and correct, and that the unique username and password, or digital signature that the Alcohol and
Tobacco Tax and Trade Bureau assigned to me are intended as my original signature. I intend that such submissions be treated as bearing an
original signature for all intents and purposes when submitting applications electronically via COLAs Online system.
17. REQ UESTOR’S SIGNATURE
18. DATE
D – APPROVAL REQUIRED: Signature of the company official with signature authority required to grant access to COLAs Online.
19. COMPANY APPROVAL SIGNATURE
20. PRINT NAME AND TITLE OF COMPANY APPROVAL OFFICIAL
21. DATE
FOR TTB USE ONLY
USER VERIFICATION COMPLETED
DATE
COMMENTS
SYSTEM OWNER APPROVAL
DATE
COMMENTS
TTB OPERATIONS COMPLETED
DATE
COMMENTS
SYSTEM ADMINISTRATOR COMPLETED
DATE
COMMENTS
USER NOTIFICATION COMPLETED
DATE
COMMENTS
TTB F 5013.2 (04/2012)
PREPARER/REVIEWER
ADD PERMIT
INSTRUCTIONS
You must complete this form in order to receive a User ID and password to obtain access to TTB's COLAs Online System. Each user must obtain an
individual User ID and password which is not to be shared with anyone. Sharing your User ID and password can result in cancellation of your COLAs
Online privileges.
Section A – You must check the appropriate box:
(1) Check New User for full access to COLAs Online if you have not been previously supplied with a User ID and password. Persons with wholesalers permits
can only apply if relabeling.
(2) Check Preparer/Reviewer for limited access to COLAs Online (This access is used only for preparing/reviewing electronic applications).
(3) Check Modify User/Add Permit only if you already have a User ID and password to COLAs Online. You must also complete the remainder of the form as
instructed below to include all modifications and include your previous User ID.
(4) Check Delete User if you no longer want access to COLAs Online for yourself or another user. Please provide the User ID of the user to be deleted,
if known (Section A, Item 2).
(
5) Check Reactivate User if we cancelled your original User ID due to inactivity and you wish to begin using the COLAs Online system again. You must
also complete the remainder of the form as instructed below and include your previous User ID.
Section B - You must enter the required information about the individual requesting access to COLAs Online in items 3 - 14. Item 11 should only be
completed by third party filers (e.g. trade associations, law firms, consultants). Third party filers who have not previously been assigned a Rep ID
number must request one from ALFD at 1-866-927-2533, before submitting this form.
Section C - You must enter the required information about the company for which you are requesting to file applications. This information must appear
exactly as it does on the Plant Registry, Basic Permit, or Brewer's Notice. Be sure to enter the correct number in item 16 (example: BW-PA-00, PA-I-00,
DSP-PA-00, BR-PA-AAA). If you are filing for multiple Registry/Permit/Brewer's Notice Numbers, you may include a list of them on a separate sheet attached
to this form. The attached list must include the company name and address, Registry, Permit or Brewer's Notice Number, and approval signature by a
company official with signing authority for each permit for which you are requesting access. Any person without signature authority must also attach a
separate TTB F 5000.8, Power of Attorney, for each company on behalf of which they will be filing label applications.
Section D - A company official with TTB signing authority must sign, print his or her name and title, and date the form in items 19-21.
You must send the original of this form to:
Advertising, Labeling and Formulation Division (ALFD)
Alcohol and Tobacco Tax and Trade Bureau
1310 G Street, N.W.
Box 12
Suite 400E
Washington, DC 20005
Your User ID and temporary password will be sent to you via e-mail.
PRIVACY ACT INFORMATION
We provide this information to comply with Section 3 of the Privacy Act of 1974 (5 U.S.C. 552a(e)(3)).
We require this information under the authority of 27 U.S.C. 205(e). You must disclose this information so we can identify the company on whose
behalf the applicant claims to act, to verify the scope of the applicant’s authority to act, and to evaluate the applicant’s qualifications for access to the
system.
We use this information to approve, grant, and control access to sensitive information systems. In addition, the information may be disclosed to
other Federal, State, and local law enforcement and regulatory agency personnel to verify information on the application and to aid in the perfor-
mance of their duties. The information may further be disclosed to the Justice Department if it appears that the furnishing of false information may
contribute to a violation of Federal law. Disclosure may otherwise be made pursuant to the routine uses most recently published in the Federal
Registry for ATF’s Regulatory Enforcement Records System (Treasury/ATF.008).
If you fail to supply complete information then there will be a delay in the processing of your application.
PAPERWORK REDUCTION ACT NOTICE
This request is in accordance with the Paperwork Reduction Act of 1995. We use this information to authenticate end users in the program to
electronically file Certificates of Label Approval. The information is used by the Government to verify the identity of the end users prior to issuing
them passwords. The information we request is voluntary, however, if the requested information is not submitted, the users will not be granted a
password and cannot participate in the electronic filing program.
The estimated average burden associated with this collection is 19 minutes per respondent or recordkeeper depending on the individual circum-
stances. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be directed to the Reports
Management Officer, Regulations and Rulings Division, Alcohol and Tobacco Tax and Trade Bureau, Box 12, Washington, DC 20005.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a current, valid
OMB control number.
TTB F 5013.2 (04/2012)
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Form 1.: NEW USER MODIFY USER DELETE USER (Alcohol and Tobacco tax and Trade Bureau)

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Completed 15 July 2021

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