DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
MONTHLY REPORT OF PROCESSING OPERATIONS
1. PLANT NUMBER
2. MONTH AND YEAR
OMB No. 1513-0041 (04/30/2017)
3. NAME OF PROPRIETOR
5. Employer Identification Number (EIN)
1.
Every proprietor engaged in processing operations must prepare this form each month in duplicate.
2.
The proprietor must forward the original to the Director, National Revenue Center, 550 Main St, Ste 8002, Cincinnati, OH
45202-5215, on or before the 15th day of the month following the month for which prepared.
3. The copy is to be kept on file by the proprietor.
PART I - BULK INGREDIENTS PART II - FINISHED PRODUCTS
TRANSACTION
BOTTLED
(Proof gallons)
PACKAGED
(Proof gallons)
TRANSACTION WINE
(Proof gallons)
SPIRITS
(Proof gallons)
(a)
(b) (c) (a) (b) (c)
1. ON HAND FIRST OF MONTH
2. RECEIVED (Other than line 3)
4. ALCOHOL, FLAVOR, MATERIALS DUMPED
5. WINE MIXED WITH SPIRITS
6. DUMPED FOR FURTHER PROCESSING
3. ALCOHOL FOR FUEL USE RECEIVED FROM
CUSTOMS CUSTODY
7. GAINS
8. TOTAL - LINES 1 THROUGH 7
9. BOTTLED OR PACKAGED
10. WINE MIXED WITH SPIRITS
11. USED FOR DENATURATION
12. TRANSFERRED IN BOND
13. WITHDRAWN TAX DETERMINED
15. WITHDRAWN WITHOUT PAYMENT OF TAX:
FOR ADDITION TO WINE
16. FOR EXPORTATION & TRANSFER TO C.B.W.
17. TRANSFERRED TO PRODUCTION ACCOUNT
FOR REDISTILLATION
14. WITHDRAWN FREE OF TAX: FOR U.S., HOSPITAL,
SCIENTIFIC, OR EDUCATIONAL USE
18. WITHDRAWN FOR RESEARCH, DEVELOPMENT,
OR TESTING (Including Gov. samples)
19. DESTROYED
21.
23.
22.
24. LOSSES
25. ON HAND END OF MONTH
26. TOTAL - LINES 9 THROUGH 25
20. USED FOR REDISTILLATION
TTB F 5110.28 (03/2016)
27. ON HAND FIRST OF MONTH
28. BOTTLED OR PACKAGED
29. RECEIVED
30. INVENTORY OVERAGES
31. TOTAL - LINES 27 THROUGH 30
32. TRANSFERRED IN BOND
33. WITHDRAWN TAX DETERMINED
34. WITHDRAWN FREE OF TAX: FOR U.S. HOSPITAL,
SCIENTIFIC, OR EDUCATIONAL USE
35. WITHDRAWN WITHOUT PAYMENT OF TAX:
FOR ADDITION TO WINE
36. FOR EXPORTATION, VESSELS, AND AIRCRAFT,
AND TRANSFER TO C.B.W.
37. TRANSFERRED TO PRODUCTION ACCOUNT
FOR REDISTILLATION
38. WITHDRAWN FOR RESEARCH, DEVELOPMENT,
OR TESTING (Including Gov. samples)
39. DESTROYED
40. DUMPED FOR FURTHER PROCESSING
41.
42.
43.
44. RECORDED LOSSES
45. INVENTORY SHORTAGES
46. ON HAND END OF MONTH
47. TOTAL - LINES 32 THROUGH 46
1
Bottled nonindustrial (beverage) use spirits may not be received or transferred in bond.
4. LOCATION OF PLANT