Form TTB F 5200.7 TTB F 5200.7 Schedule of Tobacco Products, Cigarette Papers or Tubes

OMB No. 1513-0034 (03/31/2008)
1. SERIAL NUMBER
(Begin with “1” January
1 each year)

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

SCHEDULE OF TOBACCO PRODUCTS, CIGARETTE PAPERS OR TUBES
WITHDRAWN FROM THE MARKET
(See Instructions Below)
REQUEST FOR DISPOSITION AUTHORIZATION

Operation is desired, as indicated, of the cigars, cigarettes, chewing tobacco, snuff, pipe tobacco, roll-your-own tobacco, cigarette papers, and
cigarette tubes described below, withdrawn from the market after removal from factory or customs custody.
2.

NAME AND MAILING ADDRESS OF TAXPAYER (Number and street or P.O. Box, city, State and ZIP Code) 5.
2a. EIN (Employer Identification Number)

2b. PERMIT NUMBER
3.

LOCATION WHERE ARTICLES ARE ASSEMBLED (Number and street, city and State)

6.

These articles taxed under 26 U.S.C.
5701 (Produced in U.S.A. or a foreign
country)
or
These articles taxed under 26 U.S.C.
7652(a) (Produced in Puerto Rico)
or
These articles taxed under 26 U.S.C.
7652(b) (Brought in from U.S.Virgin
Islands)
Tax has been paid on articles listed hereon
or

4.

IDENTITY OF FACTORY OR FACTORIES FROM WHICH ARTICLES WERE REMOVED

4a. PERMIT NUMBER
7.

DISPOSITION TO BE MADE OF ARTICLES (Select only one)
RETURNED TO BOND

TO BE DESTROYED

MPORTED ARTICLES TO NON-TAXPAID STATUS,

Tax has not been paid on articles listed
hereon but such tax was determined on (date) in accordance
with the provisions of applicable
regulations.
8. DATE DISPOSITION DESIRED

REDUCED TO MATERIALS

7a. PERMIT NUMBER OF FACTORY RECEIVING ARTICLES

KIND OF ARTICLES
SALE
(small cigarettes, large cigars, NUMBEROF PRICE PER
chewing tobacco, snuff, etc.) CONTAINERS
M1
(a)
(b)
(c)

9. DESCRIPTION OF ARTICLES
NUMBEROF
TOTAL SALE PRICE2
LBS./OZ.IN
TOTAL
NUMBER
OF
(col. (c) x col.
EACH
POUNDS/OUNCES
(e) ÷ 1000)
CONTAINER
(e)
(f)
(d)

RATE OF
TAX
(g)

AMOUNT OF
TAX
(h)

10. TOTAL $
1

FOOTNOTES: Complete only for large cigars. Enter the taxable sale price per thousand. (See instructions.)
2
Complete only for large cigars with a sale price of not more than $235.294 per thousand.
THIS FORM IS NOT A CLAIM and its submission does not affect the statutory period of limitations for filing claims. Claim must be filed by separate
document on TTB F 5620.8 within the period prescribed by law. See instruction (4.) on reverse.
11. SIGNATURE AND TITLE OF TAXPAYER (This schedule shall be signed by the individual owner, member of firm, officer
of corporation, or other person duly authorized by the taxpayer to sign.)
TTB F 5200.7 (7/2006)

12. DATE OF SCHEDULE

DISPOSITION AUTHORIZATION
The taxpayer is authorized to dispose of the articles listed hereon, in the manner indicated, without TTB supervision.
SIGNATURE OF TTB OFFICER

DISPOSITION

DISPOSITION OF ARTICLES
QUANTITY
(Kind of article)
(Kind of article)

(Kind of article)

DATE

(Kind of article)

13. RECEIVED INTO FACTORY
(Show permit No.)
14. REDUCED TO MATERIALS
15. DESTROYED BY (Show method)
16. TOTAL
TTB OFFICER’S CERTIFICATE: I have inspected the articles and find that they are correctly described in this schedule, except as indicated
below, and have supervised their disposition as shown under “Disposition of Articles.” (If no exceptions, so indictate below.)
EXCEPTIONS:
SIGNATURE AND TITLE OF TTB OFFICER

DATE

CERTIFICATE OF DISPOSITION BY TAXPAYER: Under the penalties of perjury, I declare that this schedule is true and correct and that the
articles listed on it were disposed of as shown under “Disposition of Articles.”
SIGNATURE AND TITLE OF TAXPAYER (This certificate shall be signed by the individual owner, member of firm, officer of corporation, or other
person authorized by the taxpayer to sign.)

DATE

INSTRUCTIONS
1. ASSEMBLY OF ARTICLES - Prior to submitting this schedule to the
National Revenue Center, Alcohol and Tobacco Tax and Trade Bureau
for disposition authorization, the taxpayer assembles the articles
according to the applicable rate of tax, (1) in or adjacent to a factory if
the articles are to be returned to bond, or (2) at any suitable place if the
aricles are to be destroyed or reduced to materials.

2. PREPARATION
PREPARATIONOF
OF SCHEDULE
SCHEDULE -- This
taxpayer in
This schedule
scheduleisisprepared
preparedby
bythe
the
triplicate in
to triplicate
show theto
following
information:
In block 7, whether
taxpayer
show the
following information:
In blockthe
7, articles are
whether
the articles
are to be
returned
bond, orarticles,
in the to a
to be destroyed
or returned
todestroyed
bond (or, inorthe
case oftoimported
case
of imported
articles,
tobe
a non-taxpaid
status, orand
are the
to be
reduced
to of
or are to
reduced to materials,
permit
number
nontaxpaid
status)
materials.
block 7a.
thearticles.
permit number
the factoryIn
receiving
such
In blockof4,the
thefactory
permit receiving
number orsuch
location of
articles.
In or
block
4, thefrom
location
and
block 4a,
theremoved
permit number,
the factory
factories
which
theinarticles
were
or, in theofcase of
the
factoryarticles,
or factories
from which
articles
were
the tax was
paid. In
imported
the location
of thethe
port
director
of customs
or identity
of other
block
In column
each
of articles
as (a),
small
cigarettes,
office9:
where
the tax(a),
was
paid.kind
In block
9: Insuch
column
each
kind of articles
large cigarettes, small cigars, large cigars, chewing tobacco, snuff, pipe
such as small cigarettes, large cigarettes, small cigars, large cigars, chewing
tobacco, roll-your-own tobacco, cigarette papers, or cigarette tubes. In
tobacco, snuff, pipe tobacco, roll-your-own tobacco, cigarette papers, or
column (b), number of containers (packages) of cigars, cigarettes,
cigarette tubes. In column (b), number of containers (packages) of cigars,
chewing tobacco, snuff, pipe tobacco, roll-you-own tobacco, cigarette
cigarettes,
chewing
tobacco,
pipe
tobacco,ofcigarette
tubes
or cigarette
papers.
In snuff,
column
(c),tobacco,
the saleroll-you-own
price per thousand
tubescigars.
or cigarette
papers.
theprice
sale price
per thousand
of large
large
Show
either In
thecolumn
taxable(c),
sale
as supported
by records,
cigars.
Show
either
theprice
taxable
sale price
supported
bysize
records,
or else
or
else the
lowest
sale
applicable
to as
that
brand and
of cigars
the lowest
salemanufacturer’s
price applicable
to that
brand
of cigars
shown
on the
basic
record
ofand
salesize
prices
duringshown
the on the
manufacturer’s
basic record
of sale
during the
period that
period
that this record
is required
toprices
be retained.
In column
(d),this
the record is
requiredortoweight
be retained.
column
(d), the
number or
thethe
article
number
of the In
article
in each
container.
In weight
columnof(e),
totalin each
number
or weight
of cigars,
chewing
tobacco,
snuff,
roll-youcontainer.
In column
(e), the cigarettes,
total number
or weight
of cigars,
cigarettes,
chewing
own
tobacco,
tobacco, cigarette
tubes,
or cigarette
papers.
Inor cigarette
tobacco,
snuff,pipe
roll-you-own
tobacco, pipe
tobacco,
cigarette
tubes,
column
the total(f),
sale
only price
of large
with
a sale
price
of not
papers.(f),
In column
theprice
total sale
onlycigars
of large
cigars
with
a sale
price of
more
than $235.294
per thousand.
In column
(g), the (g),
ratethe
of tax
not more
than $235.294
per thousand.
In column
rate of tax
applicable
column
(h),(h),
thethe
respective
amount
of tax.
applicabletotothat
thatarticle.
article.InIn
column
respective
amount
of tax.

3. REQUEST FOR DISPOSITION - When the articles are assembled and
this schedule is prepared, the taxpayer (or his authorized representative)
executes the form in block 11 and forwards all three copies to the
Director, National Revenue Center, Alcohol and Tobacco Tax and Trade
Bureau. The National Revenue Center will either assign a TTB officer to
verify the schedule and supervise disposition of the articles or authorize
the taxpayer to dispose of the articles without supervision by executing
the disposition authorization on two copies of the schedule returned to
the taxpayer. Where a TTB officer is assigned, he, or she, upon
completion of his inspection, returns to the taxpayer two verified copies
of the schedule where claim for credit or refund is to be made and one
verified copy where claim for allowance is to be made. Where the
Alcohol and Tobacco Tax and Trade Bureau authorized the taxpayer to
dispose of the articles without supervision, the taxpayer (or his
authorized representative), upon completion of the disposition executes
the taxpayer’s certificate of disposition on both copies of the schedule.
4. MANNER OF FILING CLAIM - The original of this schedule, after the proper
certificate has been executed, may be used to support a claim on
TTB F 5620.8. The duplicate of the schedule is, in any case,
retained by the taxpayer. Where claim is made, TTB F 5620.8 is
filed by the taxpayer with the:
Director, National Revenue Center, TTB
550 Main St, Ste 8002
Cincinnati, Ohio 45202-5215

PAPERWORK REDUCTION ACT NOTICE
This request is in accordance with the Paperwork Reduction Act of 1995. The information collection is used to support claims for tax credit or refund on
tobacco products to be withdrawn from the market. The information is mandatory by statute (26 U.S.C. 5705).
The estimate average burden associated with this collection of information is 45 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 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 person is not required to respond to, a collection of information unless it displays a currently valid OMB
control number.
TTB F 5200.7 (7/2006)