Form TTB F 5100.16 TTB F 5100.16 Application for Transfer of Spirits and/or Denatured Spi

OMB No. 1513-0038 (09/30/2006)
1. SERIAL NUMBER (Begin with
“1” each January 1)

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 below.)
PART I - APPLICATION
APPLICATION IS MADE FOR TRANSFER OF SPIRITS AND/OR DENATURED SPIRITS IN BOND, AS INDICATED BELOW
2. TO BE TRANSFERRED
3. TRANSFERS WILL BE RECEIVED AT:
a. PLANT NUMBER

SPIRITS

b. ADDRESS

DENATURED SPIRITS
4. TRANSFERS WILL BE MADE FROM:
a. PLANT NUMBER

b. ADDRESS

a. APPROVAL DATE OF MY
BOND (TTB F 5110.56) IS:

b.

c. OPERATED BY

5. BOND INFORMATION (Complete 5a., plus 5b. or 5c.)
c.

I HAVE MAXIMUM BOND COVERAGE
UNDER 27 CFR 19.245 - NO LIMIT TO
AMOUNT OF SHIPMENTS

I HAVE LESS THAN MAXIMUM BOND
COVERAGE UNDER 27 CFR 19.245. MY
AMOUNT OF OPERATIONS COVERAGE IS:
$

6. SHIPMENT INFORMATION (Complete 6a. and/or 6b. below ONLY IF 5c. ABOVE IS CHECKED)
a.

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. above
divided by $27.00 per wine gallon):

PROOF GALLONS

IMPORTANT
NOTICE

b.

WINE GALLONS

THE 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

10. BY (Signature and Title)

9. PROPRIETOR

PART II - APPROVAL
I certify the penal sum of the applicant’s bond is sufficient to cover the spirits and/or denatured spirits indicated. APPLICATION IS APPROVED.
11. DATE

TTB F 5100.16 (8/2006)

12. SIGNATURE OF DIRECTOR, NATIONAL REVENUE CENTER

INSTRUCTIONS
APPLICATION
1. When a proprietor of a distilled spirits plant desires to have spirits or denatured spirits transferred to him/her in bond from another domestic plant, he/she must
make application for such 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.
2. The proprietor must: (a) hold a current operations or unit bond in the maximum penal sum, or (b) hold a current bond 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 bond is in less than the maximum penal sum.
3. 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 for 3 years.

APPLICATION

TERM OF APPLICATION
The approved application remains in effect until the bond is terminated. 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 USC 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, Washington, DC 20220.
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 5100.16 (8/2006)