OMB No. 1513-0038 (11/30/2020)
DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
APPLICATION FOR TRANSFER OF SPIRITS AND/OR
DENATURED SPIRITS IN BOND
(See instructions on the back of this form. See 27 CFR 19.401 to 19.407
and 19.733 to 19.739)
1. Serial Number
(Begin with “1” each January 1)
YEAR SERIAL #
20
PART I - APPLICATION
APPLICATION IS MADE FOR TRANSFER OF SPIRITS AND/OR DENATURED SPIRITS IN BOND, AS INDICATED BELOW.
* Each Proprietor is responsible for ensuring that transferred products are suitable for use in their qualified plant operations.
SHIPPING DISTILLED SPIRITS (DSP) PLANT OR ALCOHOL FUEL PRODUCER (AFP)
2. This plant will transfer spirits denatured spirits to the receiving plant listed in Item 4.
3a. Registry /Permit Number
DSP -
AFP - -
-
3b. Shipping DSP/AFP Company Name 3c. Shipping DSP/AFP Premises Address
RECEIVING DISTILLED SPIRITS PLANT (DSP) OR RECEIVING ALCOHOL FUEL PLANT (AFP)
4a. Registry/Permit Number 4c. Receiving DSP/AFP Premises Address 4b. Receiving DSP/AFP Company Name
- DSP -
The receiving plant has the following operations bond coverage (Complete 5a, 5b, or 5c):
5a.
5b.
I am required to hold a bond
under 27 CFR 19.151. I have
maximum bond coverage
under 27 CFR 19.166 or 19.700 - no
limit to amount of shipments. The
effective date of my bond listed on
TTB F 5110.56 (next to Amount of
Bond) is:
5c.
(Complete 6a and/or 6b below only if 5c is selected.)
6a. 6b.
Quantity of Spirits Authorized to be Transferred
(Computation: Amount shown in 5c above divided by $13.50 per
proof gallon):
Quantity of Denatured Spirits Authorized to be Transferred
(Computation: Amount shown in 5c divided by $27.00 per wine gallon):
PROOF GALLONS WINE GALLONS
IMPORTANT
NOTICE
The receiving proprietor is responsible for ensuring that the liability on all spirits and denatured spirits “on hand” and “in
transit” will not exceed the bond coverage as shown in 5c above.
7. Remarks:
8. Date 9. Name and Title of Authorized Person for Receiving Plant 10. Receiving Proprietor Signature
TTB F 5100.16 (08/2017)
11. Date 12. Signature of Director, National Revenue Center
I certify that the penal sum of the applicant’s bond is sufficient to cover the spirits and/or denatured spirits indicated. APPLICATION IS APPROVED.
PART II – TTB APPROVAL
EDITIONS PREVIOUS TO 11/2016 ARE OBSOLETE
AFP - -
I am not required to hold a bond
under 27 CFR 19.151. I withdraw
spirits for deferred payment of tax, I
was liable for not more than $50,000 in
taxes in the preceding calendar year, I
reasonably expect to be liable for not
more than $50,000 during the current
calendar year, and I will not receive trans-
fers of spirits for industrial use.
I am required to hold a bond under 27
CFR 19.151. I have less than maximum
bond coverage under 27 CFR 19.166 or
19.700. The amount of my operations coverage
is
The effective date of my bond listed on TTB F
5110.56 (next to Amount of Bond) is:
$
WINE GALLONS
INSTRUCTIONS
1.
When a proprietor of a distilled spirits plant or an alcohol fuel
plant desires to have spirits or denatured spirits transferred
to him/her in bond from another domestic plant, he/she must
make application for the transfer on this form, in triplicate,
and submit all copies to the Director, National Revenue
Center, Alcohol and Tobacco Tax and Trade Bureau, 550
Main St., Ste. 8002, Cincinnati, OH 45202-5215. This
application must be approved before any spirits or
denatured spirits are transferred in bond between the
plants.
2. In-bond shipments must be authorized transfers. For
example, industrial (nonbeverage) spirits may not be
transferred to a plant whose permitted operations are
solely non-industrial (beverage).
3.
Unless the receiving proprietor is not required to hold a bond,
the receiving proprietor must:
(a) hold a current DSP operations or unit bond or Alcohol
Fuel Producer bond in the maximum penal sum, or
(b) if the bond is in less than the maximum penal sum,
hold a current bond with Distilled Spirits Plant operations
or Alcohol Fuel Producer bond coverage sufficient to
cover tax on the spirits or denatured spirits to be
transferred (in addition to all other liabilities chargeable
against such bond).
If the receiving proprietor has more than one current bond
(i.e. an original bond and a strengthening bond), show the
information for each current bond in the space provided.
4. The Serial Number in Item 1 must include the year. The
first application for transfer in bond filed in the year 2011
must be numbered, “2011-1”, and the next application,
5. Spirits transferred from an Alcohol Fuel Plant to a Distilled
Spirits Plant may only be used in the manufacture of fuel
(see 27 CFR 19.407(a)(4))
.
6. Alcohol bottled for Industrial purposes, as prescribed by
27 CFR 19.366, may be transferred between the bonded
premises of distilled spirits plants in accordance with the
procedures prescribed in 27 CFR 19.403 – 27 CFR 19.407
for bulk distilled spirits (See 27 CFR 19.402).
7. If the application is approved the Director, National
Revenue Center, will complete Part II on all copies of the
form, retain one copy, and return the remaining copies to
the applicant. The applicant must deliver one of the
approved copies to the consignor, and retain one copy for
his/her files. This information collection must be retained
as long as the information shown is current.
TERMINATION OF APPLICATION
The approved application remains in effect until the bond is
terminated (or replaced). In the case where there is less than
a maximum bond, the approved application terminates when
the penal sum is changed. If an applicant desires to terminate
an approved application at an earlier date, he/she must:
(a) retrieve the consignor’s copy, and (b) return this copy,
together with his/her own copy to the Director, National
Revenue Center, for cancellation.
PAPERWORK REDUCTION ACT NOTICE
This request is in accordance with the Paperwork Reduction Act of 1995. The information collection is used to make a determination of
the eligibility of the person to withdraw and use taxable commodities on which tax has not been paid. The information required is
mandatory by statute, 26 U.S.C. 5005(c), and is required to obtain or retain a benefit.
The estimated average burden associated with this collection of information is 12 minutes per respondent or recordkeeper, depending
on individual circumstances. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden
should be addressed to the Reports Management Officer, Regulations and Rulings Division, Alcohol and Tobacco Tax and Trade
Bureau, 1310 G Street, NW., Box 12, Washington, DC 20005
current, valid OMB control number.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a
TTB F 5100.16 (08/2017)
EDITIONS PREVIOUS TO 11/2016 ARE OBSOLETE
“2011-2” and so on. As of January 1, 2012, the numbering
starts over with “2012-1”, then “2012-2”, and so on.