Form TTB F 5110.75 TTB F 5110.75 Alcohol Fuel Plant Report

Form Approved: OMB No. 1513-0052 10/31/2006

1. PERMIT NUMBER

DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU

ALCOHOL
FUELPLANT
PLANT REPORT
ALCOHOL
FUEL
REPORT
GENERAL INSTRUCTIONS
1. Each proprietor of an alcohol fuel plant must file this annual
4. Report is due by January 30th following the end of the calendar year.
report of plant operations. A report is due even if no operations
5. Report spirits in proof gallons and alcohol fuel in wine gallons.
were conducted during the period.
Round to the nearest whole number.
2. Prepare in duplicate. Send the original to the Director, National
6. Small and medium plants complete Part I and II. Large plants
Revenue Center, Alcohol and Tobacco Tax and Trade Bureau, 550
complete Parts I and III.
Main St, Ste 8002, Cincinnati, OH 45202-5215. Keep the copy with
your AFP records for 3 years.
3. Proprietors will prepare and file a report once a year to cover all
operations for the calendar year.

PAPERWORK REDUCTION ACT NOTICE
This request is in accordance with the Paperwork Reduction Act of 1995. This information collection is used to monitor and audit the operations
of alcohol fuel plants and to collect statistics regarding the production and use of alcohol for fuel use. The information required is mandatory by statute
(26 U.S.C. 5207).
The estimated average burden associated with this collection of information is 1 hour and 6 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, D.C. 20220, and the Office of Management and Budget,
Paperwork Reduction Project (1513-0052), Washington, D.C. 20503.
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.
PART - I
1. REPORT FOR CALENDAR YEAR
SMALL

2. TYPE OF PLANT

3. NAME OF PROPRIETOR (If partnership, include name of each partner)

MEDIUM

LARGE

4. LOCATION (If no street show rural route)

PART-II
FOR SMALL AND MEDIUM PLANTS ONLY
SPIRITS TRANSACTIONS

PROOF GALLONS

PROOF GALLONS

WINE GALLONS

WINE GALLONS

1. PRODUCED
2. RECEIVED
3. RECEIVED FROM CUSTOMS CUSTODY

4.

USED ON PREMISES FOR FUEL (Do not include fuel alcohol)

5. USED IN MAKING FUEL ALCOHOL
6. DESTROYED
FUEL ALCOHOL TRANSACTIONS
7. TRANSFERRED
8. PRODUCED (Rendered Unfit)
9. USED ON PREMISES FOR FUEL
10. TRANSFERRED
Under penalties of perjury, I declare that I have examined this report, and to the best of my knowledge and belief, it is a true and complete report of
operations.
11.

12. DATE

SIGNATURE

TTB F 5110.75 (9/2006)

Page 1 of 2

PART - III
FOR LARGE PLANTS ONLY
Report the loss (line 12) or the gain (line 4) of spirits found by taking the required physical inventory for the reporting period. Report any losses by theft
separately (line 11).
SPIRITS TRANSACTIONS
PROOF GALLONS
PROOF GALLONS
1. ON HAND BEGINNING OF REPORTING PERIOD
2. PRODUCED BY DISTILLING
3. RECEIVED FROM OTHER PLANTS
4. INVENTORY GAIN
5. IMPORTED SPIRITS RECEIVED FROM CUSTOMS CUSTODY

6.
7. TOTAL (lines 1 through 6)
8. USED IN MAKING FUEL ALCOHOL
9. USED ON PLANT PREMISES FOR FUEL

(Do not include fuel alcohol)

10. USED AS DISTILLING MATERIAL OR FOR REDISTILLING
11. LOST BY THEFT
12. INVENTORY LOSS
13 TRANSFERRED TO OTHER PLANTS
14. DESTROYED
15.
16. TOTAL (lines 8 through 15)
17. ON HAND END OF PERIOD

(Subtract line 16 from line 7)

FUEL ALCOHOL TRANSACTIONS

WINE GALLONS

18. MANUFACTURED
19. DISTRIBUTED OR SOLD FOR FUEL PURPOSES
20. RECEIVED FROM CUSTOMS CUSTODY
21. USED ON PLANT PREMISES FOR FUEL PURPOSES
22. DESTROYED
23. ALL OTHER DISPOSITIONS
24 REMARKS

Under penalties of perjury, I declare that I have examined this report, and to the best of my knowledge and belief, it is a true and complete report of operations.

25. SIGNATURE

26. DATE
TTB F 5110.75 (9/2006)
Page 2 of 2