Form TTB F 5630.5R TTB F 5630.5R Special Tax "Renewal" Registration and Return

OMB NO. 1513-0113 (06/30/2011)

DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU

TAX
YEAR

2009
TOB

SPECIAL TAX “RENEWAL” REGISTRATION AND RETURN
(TAX PERIOD 7/1/2008 – 6/30/2009) (See separate instruction sheet)

SECTION I – TAXPAYER IDENTIFYING INFORMATION
1. EMPLOYER IDENTIFICATION NUMBER

BUSINESS TELEPHONE

2. OWNERSHIP INFORMATION
(Check One Box Only)

INDIVIDUAL OWNER
PARTNERSHIP

OTHER
CORPORATION

3.
TOBACCO PRODUCTS MANUFACTURES
AND TOBACCO EXPORT WAREHOUSE
PROPRIETORS (with gross receipts less than
$500,000 for most recent tax year)

SECTION II – CORRECTIONS TO PREPRINTED TAXPAYER IDENTIFYING INFORMATION
(Complete ONLY if needed and ONLY for the items requiring changes)
4. NAME (Last, First, Middle) or CORPORATE NAME (if Corporation)
6. MAILING ADDRESS

5. TRADE NAME

7. CITY, STATE, ZIP CODE

8. DATE OF CHANGE (mm/dd/yyyy)

9. EMPLOYER IDENTIFICATION NUMBER

-

10. BUSINESS TELEPHONE NUMBER

SECTION III – CHANGE IN OWNERSHIP - STATUS
(Check and complete as applicable)
11.

The person identified above no longer owns the business or is no longer engaged in the operations covered by this special
tax “renewal” registration and return. (Please complete Section V below.)
DATE BUSINESS DISCONTINUED
(mm/dd/yyyy)

12

I am the new owner of the business location identified above. I commenced business operations on
(mm/dd/yyyy). (Please complete Section II above and Section V below. As needed, correct/change the Special Tax
Location Registration information.)

SECTION IV – TAX COMPUTATIONS
(See Enclosed Tax Class Reference Chart)

13.
(a)
TAX CLASS

OFFICAL
USE ONLY

FF

(b)
TAX
CODE

FP

(c)
NUMBER OF
LOCATIONS

I

(d)
TAX RATE
($)

TOTAL

(e)
TAX DUE
($)

14. TOTAL TAX DUE

IF YOU OWE SPECIAL TAX FOR THIS TAX PERIOD, YOU MUST SUBMIT PAYMENT BY JULY 1, 2008
MAKE CHECK OR MONEY ORDER PAYABLE TO “ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)”, WRITE YOUR EMPLOYER
IDENTIFICATION NUMBER ON THE CHECK AND SEND IT WITH THE RETURN TO SOT TAX, 550 MAIN ST, STE 8002, CINCINNATI, OH 45202
Notice to Customers Making Payment by Check: If you send us a check, it will be converted into an electronic funds transfer (EFT). This means we will copy your
check and use the account information on it to electronically debit your account for the amount of the check. The debit from your account will usually occur within 24 hours,
and will be shown on your regular account statement. You will not receive your original check back. We will destroy your original check, but we will keep the copy of it. If
the EFT cannot be processed for technical reasons, you authorize us to process the copy in place of your original check. If the EFT cannot be completed because of
insufficient funds, we may try to make the transfer up to 2 times.

SECTION V – TAXPAYER CERTIFICATION
Under penalties of perjury, I declare that the statements in this return/registration are true and correct to the best of my knowledge and belief; that this return/registration
applies only to the specified business and location or, where the return/registration is for more than one location, it applies only to the business operations at the locations
specified on the attached Special Tax Location Registration Listing. NOTE: Violation of Title 26, United States Code 7206, with respect to a declaration under penalties of
perjury, is punishable upon conviction by a fine of not more than $100,000 ($500,000 in the case of a corporation) or imprisonment for not more than 3 years, or both, with
the costs of prosecution added thereto.

15. SIGNATURE

TTB F 5630.5R (07/2008)

16. TITLE

17. DATE

Page 1 of 3

DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU

TAX
YEAR

2009
TOB

SPECIAL TAX LOCATION REGISTRATION LISTING
(RENEWAL BUSINESS – TAX PERIOD 7/1/2008 – 6/30/2009)

INSTRUCTIONS
1. Review and verify that all preprinted business location information is correct.
2. A full street address or rural route description for the actual physical location of the business is required. A post office box number is
unacceptable, and if left uncorrected may delay or prevent registration of the location as required by law.
3. If any preprinted business location information is incorrect, line through the incorrect business location information and clearly print
or type the correct business location information.
4. If a business location is no longer in business, line through all preprinted business location information pertaining to that business
location; print or type the words “OUT OF BUSINESS”; and, show the date business activities ceased at the business location.
5. Enter business location information for new business locations in the space provided below. Please print or type all business
location information entered for each new business locations.
EMPLOYER IDENTIFICATION NUMBER:
TTB
LOCATION
NUMBER

TAX
CLASS
CODE

TRADE NAME

LOCATION ADDRESS

CITY, STATE, ZIP
CODE

BUSINESS
TELEPHONE
NUMBER

DO NOT WRITE IN THE SPACE BELOW EXCEPT TO ADD A NEW BUSINESS LOCATION
TRADE NAME

BUSINESS TELEPHONE NUMBER

(

)

LOCATION ADDRESS

CITY, STATE, ZIP CODE

TAX CODE

DATE NEW LOCATION STARTED BUSINESS (mm/dd/yyyy)

TAX CLASS

PAPERWORK REDUCTION ACT
This information is used to ensure compliance by taxpayers with P.L. 100-203, Revenue Act of 1987, P.L. 100-647, Technical Corrections
Act of 1988, and the Internal Revenue laws of the United States. The Alcohol and Tobacco Tax and Trade Bureau (TTB) uses the
information to determine and collect the right amount of tax. The estimated average burden associated with this collection is 15 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 directed 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 56305R (07/2008)

Page 2 of 3

TAX
YEAR

DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU

SPECIAL TAX LOCATION REGISTRATION LISTING
(RENEWAL BUSINESS – TAX PERIOD 7/1/2008 – 6/30/2009)

2009
TOB

EMPLOYER IDENTIFICATION NUMBER:
TTB
LOCATION
NUMBER

TAX
CLASS
CODE

TRADE NAME

LOCATION ADDRESS

CITY,
STATE, ZIP CODE

BUSINESS
TELEPHONE
NUMBER

DO NOT WRITE IN THE SPACE BELOW EXCEPT TO ADD A NEW BUSINESS LOCATION
TRADE NAME

BUSINESS TELEPHONE NUMBER
(
)
CITY, STATE, ZIP CODE

LOCATION ADDRESS
TAX CODE

TTB F 5630.5R (07/2008)

TAX CLASS

DATE NEW LOCATION STARTED BUSINESS (mm/dd/yyyy)

Page 3 of 3

SUPPLEMENTAL INSTRUCTION SHEET FOR COMPLETING
SPECIAL TAX “Renewal” REGISTRATION AND RETURN, TTB FORM 5630.5R (07/2008)
ATTENTION “PERMITTEES”
If you are no longer engaged in the operations authorized by the Alcohol and Tobacco Tax and Trade Bureau (TTB), and
have complied with all requirements for discontinuance (e.g., disposal of tobacco, filing of final report(s), etc.), you are
authorized to submit your Permit(s) and/or Notices for cancellation with this Special (occupational) Tax (SOT) Renewal. Make
sure that you have completed Items 11, 15, 16, and 17 on the first page of this form. Such cancellation will not affect your
right to reapply in the future. However, you may not engage in any operations requiring authorization until you have requalified.
If you have a permit, but you ARE NOT CONDUCTING BUSINESS for which you have been issued a permit, you MUST
FILE this tax return and attach a statement saying that you are currently “INACTIVE” and will file a new tax return before
conducting any operations in this tax year.
For assistance in disposing of tobacco, or if you need other information regarding documents to be filed, please contact the
TTB National Revenue Center at 1-877-882-3277, or (513) 684-3334 between 8 A.M. and 5 P.M. E.S.T.
1. Item 1 – Taxpayer Identifying Information – If any
taxpayer identifying information in Block 1 is incorrect,
enter only the corrected information in the appropriate
block in Section II.
2. Your tax return must contain a valid Employer
Identification Number (EIN). A missing or incorrect
EIN will result in a delay in the processing of your special
tax registration and return form, and in the issuance of
a special tax stamp. An EIN is a unique number for
business entities issued by the Internal Revenue
Service (IRS). You must have an EIN whether you are
an individual owner, partnership, corporation, or an
agency of the government. If you do not have an EIN,
contact your local IRS office immediately to obtain
one. If you submit a special tax registration and return
form that does not have an EIN, TTB may assign a
temporary identification number (beginning with XX) to
allow initial processing of the special tax registration
and return form. However, a special tax stamp, TTB
Form 5630.6A, will not be issued until you have
notified us of the issuance of a valid EIN. If your
special tax registration and return form has an XX
number or an incorrect EIN in Item 1, be sure to enter
the correct EIN in Item 9.
Do not delay the submission of your special tax
registration and return form, and any payment, past
the due date pending the receipt of a valid EIN.
Submit your EIN by separate correspondence after
receipt from the IRS.
3. Item 2 – Check only one box to describe the type of
ownership of the business identified in Item 1.
4. Item 3, – Reduced Rate Taxpayers and Exempt
Activities – You must declare your eligibility for a
reduced rate or special tax exemption each year.
The regular rates are used to compute the
amounts shown as due on the special tax
registration and return form.

5. Check Item 3 only if you are a tobacco products
manufacturer or you are the proprietor of a tobacco
export warehouse, and the gross receipts for your
entire business, from all sources (not just receipts
relating to the activity subject to special (occupational)
tax), was less than $500,000 for the tax year
immediately preceding this tax year. If your business
meets these conditions, you are eligible for a reduced
tax rate and may compute your tax using the
appropriate reduced tax rate shown on the enclosed
Tax Class Reference Chart. However, if you are a
member of a controlled group as defined in section
5061(e)(3) of the Internal Revenue Code, you are not
eligible for a reduced rate unless the total gross
receipts for the entire group are less than $500,000.
6. Item 11 – If you have discontinued business
operations, check Item 11 and enter the date of
discontinuance in the space provided and complete
Section V.
7

Item 12 – If you are the new owner of the business,
check Item 12 and complete Sections II, IV and V.
Also, correct any errors on the Special Tax “Renewal
Registration and Return.

8. Item 13 – If tax payment is due, the amount shown in
Column 13(e), as tax due, is computed by multiplying
the number of locations, Column 13(c), by the tax rate,
Column 13(d). Add additional tax classes (if
necessary) in the vacant spaces provided or attach
additional sheets.
9. Item 14 – If tax payment is due, the total tax due is
computed by adding the figures in Column 13(e).
10. If the preprinted information in Section IV is incorrect,
line through the incorrect items(s) and write in the
correct information alongside the lined out item(s).
11. See the enclosed Tax Class Reference Chart for tax
class and tax rate information.

DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU
TAX CLASS REFERENCE CHART
TAX YEAR 2009
TAX
CLASS

DESCRIPTION

TAX
RATE

Manufacturer of tobacco products
Manufacturer of tobacco products – REDUCED*
Manufacturer of cigarette papers and tubes
TOBACCO
PRODUCTS Manufacturer of cigarette papers and tubes – REDUCED*
Proprietor of export warehouse
Proprietor of export warehouse – REDUCED*

$1,000
$500
$1,000
$500
$1,000
$500

See supplemental instructions for explanation of Reduced Rates.

IF YOU NEED FURTHER ASSITANCE
CONTACT THE NATIONAL REVENUE CENTER

at 1-800-937-8864 or (513) 684-2979

TTB F 56305R (07/2008)

TAX
CODE

91
95*
92
96*
93
97*

STATUS

PAYABLE
PAYABLE
PAYABLE
PAYABLE
PAYABLE
PAYABLE