Form TTB F 5100.16 TTB F 5100.16 Application to Receive Spirits and/or Denatured Spirits

OMB No. 1513-0038 (01/31/2013)
1. Serial Number

DEPARTMENT OF THE TREASURY

(Begin with “1” each January 1)

ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)

APPLICATION FOR TRANSFER OF SPIRITS AND/OR
DENATURED SPIRITS IN BOND
(See instructions on the back of this form. See 27 CFR 19.505-510)

YEAR

SERIAL #

20

PART I - APPLICATION

APPLICATION IS MADE FOR TRANSFER OF SPIRITS AND/OR DENATURED SPIRITS IN BOND, AS INDICATED BELOW.
* Each Proprietor is responsible for ensuring that transferred products are suitable for use in their qualified plant operations.
SHIPPING DISTILLED SPIRITS (DSP) PLANT OR ALCOHOL FUEL PRODUCER (AFP)
2.

This plant will transfer

3a. Registry /Permit Number

4.

DSP -

-

AFP -

-

spirits

denatured spirits to the receiving plant listed in Item 5.

3b. Shipping DSP/AFP Company Name

3c. Shipping DSP/AFP Premises Address

The transferring plant has, at the location listed above, the following type(s) of permit(s) *:
An FAA Act BASIC PERMIT authorizing distilling, warehousing, processing and/or bottling of NON-INDUSTRIAL (BEVERAGE) SPIRITS
An OPERATING PERMIT authorizing
Warehousing bulk spirits for NON-INDUSTRIAL (BEVERAGE) use
Distilling, warehousing, and/or bottling or packaging spirits for INDUSTRIAL use

Denaturing spirits

Manufacturing articles

An ALCOHOL FUEL PRODUCER PERMIT

RECEIVING DISTILLED SPIRITS PLANT (DSP)
5a. Registry Number

DSP -

5b. Receiving DSP Company Name

5c. Receiving DSP Premises Address

-

The receiving plant has the following bond coverage (Complete 6a and 6b, or 6a and 6c)
6c. I have less than maximum OPERATIONS bond
6a. “DATE APPROVED”
6b. I have maximum OPERATIONS bond
coverage under 27 CFR 19.245 – no
coverage under 27 CFR 19.245. The amount of
from TTB F 5110.56, DSP Bond
limit to amount of shipments
my OPERATIONS coverage is:
(bottom of bond page 2)

$
(Complete 7a and/or 7b below only if 6c is selected.)
7a. Quantity of Spirits Authorized to be Transferred

(Computation: Amount shown in 6c above divided by $13.50 per
proof gallon):

PROOF GALLONS 

7b. Quantity of Denatured Spirits Authorized to be Transferred
(Computation: Amount shown in 6c divided by $27.00 per wine gallon):

WINE GALLONS 

IMPORTANT The receiving proprietor is responsible for ensuring that the liability on all spirits and denatured spirits “on hand” and “in
NOTICE
transit” will not exceed the bond coverage as shown in 6c above.
8.

Remarks:

9.

Date

10. Name and Title of Authorized Person for Receiving Plant

11. Receiving Proprietor Signature

PART II – TTB APPROVAL
I certify that the penal sum of the applicant’s bond is sufficient to cover the spirits and/or denatured spirits indicated. APPLICATION IS APPROVED.

12. Date

TTB F 5100.16 (10/2010)

13. Signature of Director, National Revenue Center

INSTRUCTIONS
1.

2.

3.

When a proprietor of a distilled spirits plant desires to have
spirits or denatured spirits transferred to him/her in bond
from another domestic plant, he/she must make
application for the transfer on this form, in triplicate, and
submit all copies to the Director, National Revenue
Center, Alcohol and Tobacco Tax and Trade Bureau, 550
Main St., Ste. 8002, Cincinnati, OH 45202-5215. This
application must be approved before any spirits or
denatured spirits are transferred in bond between the
plants.
In-bond shipments must be authorized transfers. For
example, industrial (nonbeverage) spirits may not be
transferred to a plant whose permitted operations are
solely non-industrial (beverage).
The receiving proprietor must:
(a) hold a current operations or unit bond in the maximum
penal sum, or
(b) if the bond is in less than the maximum penal sum,
hold a current bond with operations coverage sufficient
to cover tax on the spirits or denatured spirits to be
transferred (in addition to all other liabilities chargeable
against such bond).
If the receiving proprietor has more than one current bond
(i.e. an original bond and a strengthening bond), show the
information for each current bond in the space provided.

4.

The Serial Number in Item 1 must include the year. The
first application for transfer in bond filed in the year 2010
must be numbered, “2010-1”, and the next application,

“2010-2” and so on. As of January 1, 2011, the numbering
starts over with “2011-1”, then “2011-2”, and so on.
5.

Spirits transferred from an Alcohol Fuel Plant to a Distilled
Spirits Plant may only be used in the manufacture of fuel
(see 27 CFR 19.510).

6.

Alcohol bottled for Industrial purposes, as prescribed by
27 CFR 19.398, may be transferred between the bonded
premises of distilled spirits plants in accordance with the
procedures prescribed in 27 CFR 19.506 – 19.510 for bulk
distilled spirits (See 27 CFR 19.505).

7.

If the application is approved the Director, National
Revenue Center, will complete Part II on all copies of the
form, retain one copy, and return the remaining copies to
the applicant. The applicant must deliver one of the
approved copies to the consignor, and retain one copy for
his/her files. This information collection must be retained
as long as the information shown is current.
TERMINATION OF APPLICATION

The approved application remains in effect until the bond is
terminated (or replaced). In the case where there is less than
a maximum bond, the approved application terminates when
the penal sum is changed. If an applicant desires to terminate
an approved application at an earlier date, he/she must:
(a) retrieve the consignor’s copy, and (b) return this copy,
together with his/her own copy to the Director, National
Revenue Center, for cancellation.

PAPERWORK REDUCTION ACT NOTICE
This request is in accordance with the Paperwork Reduction Act of 1995. The information collection is used to make a determination of
the eligibility of the person to withdraw and use taxable commodities on which tax has not been paid. The information required is
mandatory by statute, 26 U.S.C. 5005(c), and is required to obtain or retain a benefit.
The estimated average burden associated with this collection of information is 12 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, 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 5100.16 (10/2010)