Form TTB F 5210.9 TTB F 5210.9 Inventory - Manufacturer of Tobacco Products

OMB No. 1513-0032 (01/31/2007)
FOR TTB USE ONLY

DEPARTMENT OF THE TREASURY

AUDITED BY

ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)

INVENTORY - MANUFACTURER OF TOBACCO PRODUCTS
(File in duplicate - See instructions b e l o w)
1.

NAME OF MANUFACTURER

3.

ADDRESS OF FACTORY (Number, Street, City, State and ZIP Code)

4.

TYPE OF INVENTORY (Check applicable box)
COMMENCING

DATE OF AUDIT
2.

CONCLUDING

ARTICLE

6.

PERMIT NUMBER

TP-

5.

DATE OF INVENTORY

SPECIAL
IN BOND

7.

TAX DETERMINED

a. Small Cigarettes (number)
b. Large Cigarettes (number)
c. Small Cigars (number)
d. Large Cigars (number)
e. Chewing Tobacco (pounds and ounces)
f. Snuff (pounds and ounces)
g. Pipe Tobacco (pounds and ounces)
h. Roll-Your-Own Tobacco (pounds and
ounces)
Under the penalties of perjury, I declare that this inventory includes all cigars, cigarettes, chewing tobacco, snuff, pipe tobacco, and roll-yourown tobacco required to be accounted for and is, to the best of my knowledge and belief, true and accurate.
8.

SIGNATURE

9.

DATE

10. TITLE OR STATUS (State whether individual owner, member of firm, or if officer of corporation, give title)

TO BE EXECUTED ONLY WHEN INVENTORY IS VERIFIED BY TTB OFFICER. I have examined the cigars, cigarettes, chewing tobacco, snuff, pipe
tobacco, and roll-your-own tobacco reported in this inventory and am satisfied that the inventory is accurate.
11. SIGNATURE OF TTB OFFICER

12. TITLE

13. DATE

PAPERWORK REDUCTION ACT NOTICE
This request is in accordance with the Paperwork Reduction Act of 1995. The purpose of this information is to establish a basis for verification of tax
liability. This form is subject to TTB inspection. Completion of this form is mandatory. (26 U.S.C. 5721 and 5741).
The estimated average burden associated with this collection of information is 5 hours 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 Reports Management Officer, Regulations and Rulings Division, Alcohol and Tobacco Tax and Trade Bureau, Washington, D.C. 20220.
An agency may not conduct or sponsor, and a individual is not required to respond to, a collection of information unless it displays a current, valid OMB
control number.

TTB F 5210.9 (11/2006)

INSTRUCTIONS
When required. Each manufacturer is required by regulations (27 CFR
Part 40) to make a true and accurate inventory at the time of commencing
business, at the time of concluding business, and at such other time as any
TTB officer may require. Such inventories will be made and the date
entered in item 5 of this form as the DATE OF INVENTORY as follows:
Commencing inventory. To be made as of the beginning of business
on the date of commencing business, including requalification (but not
merely the amendment of a permit), including the reopening of the
business upon a change of location, and including the commencing of
business upon transfer of ownership. The effective date of the permit
is shown thereon will be the DATE OF INVENTORY.
Concluding inventory. To be made as of the close of business on
the date the business is concluded, including transfer of ownerhip, and
including a change of location. Where a fiduciary takes over the business for liquidation and files a statement and extension of coverage of
the manufacturer's bond, as provided by regulations, no concluding
inventory is necessary until the fiduciary liquidates the business. The
DATE OF INVENTORY will be the date the permit is surrendered, or in
the case of transfer of ownership the date preceding the commencing
inventory of the successor.

Special inventory. To be made whenever required by any TTB officer.
When such an inventory is made as of the beginning of business on
any day, that date will be entered as the DATE OF INVENTORY, and
when made as of the close of business on any day, will be considered
as made at the beginning of business of the next calendar day and
such date entered as the DATE OF INVENTORY.
Items to be included. Regulations (27 CFR Part 40) require that inventories include all cigars, cigarettes, chewing tobacco, snuff, pipe tobacco
and roll-your own tobacco required to be accounted for in the records.
This includes all cigars, cigarettes, chewing tobacco, snuff, pipe tobacco
and roll-your-own tobacco in the factory and all cigars, cigarettes, chewing
tobacco, snuff, pipe tobacco, and roll-your-own tobacco stored outside the
factory when the TTB official has authorized such storage.
Preparation and disposition. The inventory should be prepared by the
manufacturer in duplicate, the original submitted to the Director, National
Revenue Center, 550 Main St, Ste 8002, Cincinnati, OH, 45202-5215. The
duplicate copy will be retained by the manufacturer.
Verification by TTB officer. The TTB officer's certificate will be executed
only when a TTB officer requires verification.

TTB F 5210.9 (11/2006)