Form TTB F 5120.36 TTB F 5120.36 Wine Bond

OMB No. 1513-0009 (10/31/2009)
REGISTRY NUMBER

DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)

WINE BOND

EFFECTIVE DATE

( Print this form as a 2-sided document. Submit duplicate originals. See additional instructions on page 3.)
PRINCIPAL/OBLIGOR NAME AND PREMISES ADDRESS
(Number, Street, City, State, ZIP Code)

PRINCIPAL/OBLIGOR MAILING ADDRESS
(If different than Premises Address)

BOND KIND (Select only one)
ORIGINAL

STRENGTHENING

SUPERSEDING

EIN:
BOND COVERAGE (Select applicable box(es))
OPERATIONS $

DEFERRAL $

TOTAL PENAL SUM* $

*(Total Penal Sum equals OPERATIONS plus DEFERRAL Coverage on this bond. Deposited collateral must also equal Total Penal Sum.)
BOND CATEGORY (Select only one category (i.e. ‘Surety,’ ‘Cash,’ or ‘Treasury Note/Bond’) and complete corresponding items to right of selection.)
SURETY:

SURETY NAME

CASH:

CHECK NUMBER(S) (i.e. personal check, cashier’s check, money order, etc.)

TREASURY NOTE/BOND**

BOND NUMBER

TREASURY NOTE/BOND CUSIP NO.

TREASURY NOTE/BOND INTEREST RATE

%

TREASURY NOTE/BOND ISSUE DATE

TREASURY NOTE/BOND MATURITY DATE

** This bond is secured by the Treasury collateral (T-Note) described above or by a T-Note resulting from reinvestment of the full proceeds from the T-Note
described above. T-Note collateral reinvestment automatically will occur upon maturity, unless the obligor notifies TTB in writing at least 45 days prior to
the maturity date that the T-Note proceeds should not be reinvested and the obligor requests this bond be terminated.
Witness our hands and seals this

day of

, 20

. Signed, sealed, and delivered in the presence of --

CORPORATIONS/PARTNERSHIPS, OR LLCs:
State in which principal/obligor organized:
Impress
Surety
Seal

Impress principal/obligor’s corporate or LLC seal or check the checkbox
below.
The corporation/LLC has no seal.
Principal/
Obligor
Seal

Alterations made on this bond before and after execution were made with the consent of the Principal ______ and Surety ______ OR Obligor ______.

SURETY NAME

PRINCIPAL/OBLIGOR NAME

SURETY REPRESENTATIVE SIGNATURE

BY:
PRINCIPAL/OBLIGOR REPRESENTATIVE SIGNATURE

SURETY REPRESENTATIVE PRINTED NAME AND TITLE

PRINCIPAL/OBLIGOR REPRESENTATIVE PRINTED NAME AND TITLE
SIGNATURE, WITNESS 1 (if no seal)
SIGNATURE, WITNESS 2 (if no seal)

DIRECTOR, NATIONAL REVENUE CENTER APPROVAL: ON BEHALF OF THE UNITED STATES, I APPROVE THE FOREGOING BOND WHICH
HAS BEEN EXECUTED IN DUE FORM IN COMPLIANCE WITH THE APPLICABLE LAWS, REGULATIONS, AND INSTRUCTIONS.
SIGNATURE OF AUTHORIZED OFFICIAL, ALCOHOL AND TOBACCO TAX AND TRADE BUREAU

TTB F 5120.36 (05/2007)

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DATE APPROVED

PURPOSE: The above principal/obligor has filed an
application to operate, or is operating, the bonded wine
cellar or bonded winery specified.
DEFINITIONS: Definitions pertinent to this bond:
PRINCIPAL. The proprietor of the wine premises
covered by a surety bond.
OBLIGOR. The proprietor of the wine premises covered
by a collateral bond.
COLLATERAL BOND. A bond secured by tangible
assets such as cash or United States Treasury Bond or
Note.
CONDITIONS: The above principal/obligor and surety
(sureties) are bound independently and jointly for payment to
the United States in the above amount of lawful money of
the United States. In this bond, the terms principal/obligor or
surety include the heirs, executors, administrators,
successors, and assigns of the principal/obligor or surety.
Additional wine bond conditions are below. (If this bond
covers only tax deferral, only the wine bond conditions in
clauses 1, 2, and 3(a), and the Additional Wine Bond
Conditions below will apply.)
BULK WINE WITHDRAWN FROM CUSTOMS CUSTODY:
This bond covers the tax, for which the principal/obligor must
become liable, on all wine withdrawn from customs custody
in bulk containers and transferred to internal revenue bond
at a bonded wine premises.
THE PRINCIPAL/OBLIGOR MUST:
(1) Comply with all requirements of law and regulations,
now or hereafter in force, relating to the activities
covered by this bond;
(2) Pay all penalties incurred and fines imposed for
violations of law or regulations, now or hereafter in force,
relating to the activities covered by this bond;
(3) (a) Pay all taxes (including any penalties and interest in
respect of failure to file a timely return or to pay
such tax when due) on wine removed from bonded
premises:
(b) Provided, that up to $500 of the operations coverage
of a $1,000 bond ($1,000 operations coverage of a
bond of $2,000 or more) may be applied to taxes
that have been determined, but not paid on wine
removed from premises;
(4) Pay all taxes (including any penalties and interest) for
which the principal/obligor may become liable with
respect to the operation of the bonded wine premises.
Whether the transaction or operation on which liability is
based occurred on or off the bonded wine premises, and
on all wine, spirits, and volatile fruit-flavor concentrate, or
any other commodity subject to tax under 26 U.S.C.
Chapter 51, in transit to, or on the bonded wine
premises;

now or hereafter in force relating thereto: and (b) as to
the said wine or any part thereof withdrawn, for example,
for exportation or for use on vessels or aircraft, or for
transfer to a foreign-trade zone, or for transfer to a
Customs Bonded Warehouse (CBW), and not exported,
used or transferred, or otherwise lawfully disposed of or
accounted for, pay the tax imposed thereon by law, now
or hereafter in force, together with penalties and interest;
and
(7) As the proprietor of an adjacent wine vinegar plant, pay
all taxes, now or hereafter in force (including any
penalties or interest), for which the principal/obligor may
become liable with respect to the operation of the wine
vinegar plant, and all wine now or hereafter in transit or
on the premises of the wine vinegar plant.
ADDITIONAL WINE BOND CONDITIONS
CHANGE OF PREMISES: All stipulations, covenants, and
agreements of this bond will extend to and apply to any
change in the business address of the wine premises, the
extension or curtailment of the premises, including the
buildings thereon, or any equipment or any other change
which requires the principal/obligor to file a new or amended
application or notice, except where the change constitutes a
change in the proprietorship of the business, or in the
location of the premises. Further, this bond will continue in
effect whenever operation of the wine premises is resumed
from time to time following suspension of operations by an
alternate proprietor.
TREASURY COLLATERAL BONDS: If this bond is filed as
a collateral bond secured by a Treasury Note or Bond in an
approved Department of the Treasury holding account, this
bond is secured by the Treasury collateral identified on the
face of the bond and any Treasury collateral resulting from
rollover of the previous Treasury collateral. The Treasury
collateral identified in this bond will automatically roll over
upon maturity unless the obligor notifies the National
Revenue Center at least 45 days prior to maturity.
DEFAULT: If the Principal/Obligor of a surety bond fails to
fulfill any of the terms or conditions of this bond, the United
States may seek compensation and pursue its remedies
independently from either the principal/obligor or surety, or
jointly from both. The surety hereby waives any right or
privilege it may have of requiring, upon notice, or otherwise,
that the United States will first commence action, intervene
in any action of any nature whatsoever already commenced,
or otherwise exhaust its remedies against the
principal/obligor.
If the Obligor of a collateral bond fails to fulfill any of the
terms or conditions of this bond, the United States may apply
any outstanding tax liability (including any penalties or
interest) against the collateral deposited.

(5) Comply with all requirements now or hereafter in force,
pertaining to all wine or wine spirits received at, removed
from, or returned to the bonded premises free of tax;

EFFECTIVE DATE: If accepted by the United States, the
bond will be effective according to its terms on and after the
date without notice to the obligors. Provided, that if no
effective date is inserted in the space provided, the date of
execution will be the effective date of the bond.

(6) With respect to wine withdrawn from the bonded wine
premises without payment of tax as authorized by law
(a) comply with all requirements of law and regulations,

I/We acknowledge the terms and conditions of this bond.
Principal/Obligor (Initial) ________ Date ________,
Surety (Initial) ________ Date ________.

TTB F 5120.36 (05/2007)

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the bond to execute it for the principal/obligor, unless an
authorization has been previously filed with the Director,
National Revenue Center, Alcohol and Tobacco Tax and
Trade Bureau, in which event a statement to the effect
must be attached to the bond.

INSTRUCTIONS
1. File duplicate original bonds with the Director, National
Revenue Center, Alcohol and Tobacco Tax and Trade
Bureau, 550 Main St, Ste 8002, Cincinnati, OH 452025215.
2. The name, including the full given name, of each party to
the bond will be given in the heading, and each party
must sign the bond with such party's signature, or the
bond may be executed in the party's name by an
empowered attorney-in-fact.
a. In the case of a partnership, the partnership name,
followed by the names of all its partners will be given
in the heading. In executing the bond, the partnership
name will be typed or written followed by the word "by"
and the signatures of all partners, or the signature of
any partner authorized to sign the bond for the firm, or
the signature of an empowered attorney-in-fact. The
name of the state in which the partnership is organized
will be given in the space provided above the signature
lines.
b. If the principal/obligor is an LLC, the LLC name will be
given in the heading. In executing the bond, the LLC
name will be typed or written followed by the word "By"
and the signature and title of the managing member,
any member authorized to sign the bond for the LLC,
or an empowered attorney-in-fact. The name of the
state in which the LLC is organized will be given in the
space provided above the signature lines.
c. If the principal/obligor is a corporation, the heading will
give the corporate name, the address of the principal
business office, and the address of the premises. The
name of the state in which the corporation is organized
will be given in the space provided above the signature
lines. The bond will be executed in the corporate
name, immediately followed by the signature and title
of the person authorized to act for the corporation.
3. If the bond is signed by an attorney-in-fact for the
principal/obligor, or by one of the members of a
partnership, LLC, or association, or by an officer or other
person for a corporation, there will be filed with the bond
an authenticated copy of the power of attorney, or
resolution of the board of directors, or an excerpt of the
bylaws, or other document, authorizing the person signing

4. The signature for the surety will be attested under
corporate seal. The signature for the principal/obligor, if a
corporation or LLC, also will be attested by seal if the
corporation or LLC has a seal. If the corporation or LLC
has no seal, that fact will be noted. Each signature will be
made in the presence of two persons (except where
corporate or LLC seals are affixed), who must sign their
names as witnesses.
5. A bond may be given with (a) corporate surety authorized
to act as surety by the Secretary of the Treasury, (b) by
the deposit of Government obligations. A Government
obligation is defined in 31 U.S.C. 9301 as "a public debt
obligation of the United States Government and an
obligation whose principal and interest is unconditionally
guaranteed by the Government." Such obligations
include Treasury notes or Treasury bonds, or (c) by cash
in the form of a check or similar legal tender made
payable to the Alcohol and Tobacco Tax and Trade
Bureau for deposit in an approved Department of the
Treasury holding account.
Contact the National Revenue Center toll free at 1-877882-3277 regarding allowable types of collateral.
6. If any alteration or erasure is made in the bond before or
after its execution, check the box next to the alteration
statement on page 2 and make sure that the Principal
and Surety or Sureties OR Obligor initial the statement.
7. The penal sum named in the bond will be in accordance
with 27 CFR Part 24.
8. If the bond is approved, a copy will be returned to the
principal/obligor.
9. All correspondence about the filing of this form or any
subsequent action, including termination, affecting this
bond should be directed to the Director, National
Revenue Center, Alcohol and Tobacco Tax and Trade
Bureau, 550 Main St, Ste 8002, Cincinnati, OH 452025215 or 1-877-882-3277 (toll free).

PAPERWORK REDUCTION ACT NOTICE
This request is in accordance with the Paperwork Reduction Act of 1995. The information is used by the proprietor, or the
proprietor and a surety company, as a contract to ensure tax payment. The information requested is required to obtain a
benefit and is mandatory by statute (26 U.S.C. 5172).
The estimated average burden associated with this collection of information is 1 hour 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 5120.36 (05/2007)

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