Form TTB F 5110.11 TTB F 5110.11 Monthly Report of Storage Operations

OMB No. 1513-0039 (11/30/2009)

DEPARTMENT OF THE TREASURY

REPORT COVERS

ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)

INSTRUCTIONS

MONTHLY REPORT OF STORAGE OPERATIONS

Every proprietor as a warehouseman must prepare this form monthly, in
duplicate. Forward the original to the Director, National Revenue Center
550 Main St, Ste 8002, Cincinnati, OH 45202-5215, not later than the 15th
day of the month following that for which the report is rendered.

TRANSACTIONS
(a)

The remaining copy must be retained by the proprietor. Separate
reports must be prepared for domestic spirits, imported spirits,
Puerto Rican spirits, and spirits from the U.S. Virgin Islands. Denaturing
operations must be reported on TTB F 5110.43.

WHISKY6/
DISTILLED AT
DISTILLED AT
160° AND UNDER
OVER 160°
(b)
(c)

MONTH AND YEAR
DOMESTIC SPIRITS AND ALL WINES
PUERTO RICAN SPIRITS
NAME OF PROPRIETOR

EIN

LOCATION OF PLANT

PROOF GALLONS

BRANDY
DISTILLED AT
DISTILLED AT
OVER 170°
170° AND UNDER
(e)
(d)

IMPORTED SPIRITS
VIRGIN ISLANDS SPIRITS

RUM

GIN

VODKA

(f)

(g)

(h)

PLANT NUMBER
DSPALCOHOL AND SPIRITS
190° AND OVER
UNDER 190°
(i)

(i)

OTHER (Identify)
(k)

WINE
(Proof gallons)
(l)

TOTAL
(m)

1. On hand first of month
2. Deposited in bulk storage1/
3. Received from Customs custody
4. Returned to bulk storage
5.
6. TOTAL (Lines 1 through 5)
7. Taxpaid
8. Use of the United States

WITHDRAWN FOR

9. Hospital, scientific educational use2/
10. Export
11. Transfer to foreign-trade zone
12. Transfer to CMBW
13. Use as supplies on vessels and aircraft
14. Transfer to bonded winery
15. Transfer to CBW
16. Research, development, or testing3/
17. Transferred to processing account
18. Transferred to production account4/
19. Transferred to other bonded premises
20. Destroyed
21.
22. Other Losses5/
23. On hand end of month
24. TOTAL (Lines 7 through 23)

FOOTNOTES
1

From production or by transfer in bond.

2

Does not include spirits withdrawn for experimental or
research use under 26 U.S.C. 5312; such spirits should
be reported and identified at Line 21.

3

Withdrawals under 26 U.S.C. 5214(a)(10) or 5373(b)(4).
TTB F 5110.11 (01/2009)

4

In the case of imported spirits or spirits from Puerto
Rico and the U.S. Virgin Islands, applicable only to
spirits of 185 degrees or more of proof.

5

Includes only losses determined at the time of:
(1) withdrawal

(2) dumping for mingling, or
(3) emptying or inventorying storage tanks
6

Includes domestic whisky distilled at over 160°
Proof in col. (c). All other whisky should be
reported in col. b).

Under penalties of perjury, I declare that I have examined this report and, to the best of my
knowledge and belief, it is a true, correct, and complete report of storage operations, and is
supported by true, correct, and complete commercial records which are available for inspection.
DATE
PROPRIETOR
BY: (Signature and Title)

PAPERWORK REDUCTION ACT NOTICE
This information request is in accordance with the Paperwork Reduction Act of 1995. The purpose of this information collection is to monitor the operations of industries regulated by TTB. The information is required to verify unusual activities, errors,
omissions on taxable commodities. The information required is mandatory by statute (26 U.S.C. 5207).
The estimated average burden associated with this collection of information is 2 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 the 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 current, valid OMB control number.

TTB F 5110.11 (01/2009)