Form TTB F 5220.3 TTB F 5220.3 Inventory - Export Warehouse Proprietor

OMB No. 1513-0035 (02/28/2013)
FOR TTB USE ONLY

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

AUDITED BY

INVENTORY - EXPORT WAREHOUSE PROPRIETOR

DATE OF AUDIT

(Prepare in Duplicate)
1. NAME OF PROPRIETOR

2. ADDRESS OF WAREHOUSE (Number, Street, City, State, and ZIP Code)

3. PERMIT NUMBER

EW ―
4. TYPE OF INVENTORY (Check applicable box)
COMMENCING

CONCLUDING

5. DATE OF INVENTORY
SPECIAL

6. ARTICLES IN INVENTORY * Enter quantity in pounds and fractions of a pound rounded to 2 decimal places.
LARGE CIGARS
(Number)
(a)

SNUFF
(Pounds)*
(f)

SMALL CIGARS
(Number)
(b)

PIPE TOBACCO
(Pounds)*
(g)

LARGE CIGARETTES
(Number)
(c)

ROLL-YOUR-OWN
TOBACCO
(Pounds)*
(h)

SMALL CIGARETTES
(Number)
(d)

CIGARETTE
PAPERS
(Number)
(i)

CHEWING TOBACCO
(Pounds)*
(e)

CIGARETTE
TUBES
(Number)
(j)

PROCESSED
TOBACCO
(Pounds)*
(k)

Under the penalties of perjury, I declare that this inventory includes all cigars, cigarettes, chewing tobacco, snuff, pipe tobacco, rollyour-own tobacco, cigarette papers, cigarette tubes, and processed tobacco required to be accounted for and is, to the best of my
knowledge and belief, true and accurate.
7. SIGNATURE (Print name of individual signing the form)

8. DATE

9. TITLE OR STATUS (State whether individual owner, member of firm, or if officer of corporation, give title)

TO BE EXECUTED ONLY WHEN INVENTORY IS VERIFIED BY TTB OFFICER. I have examined the cigars, cigarettes, chewing
tobacco, snuff, pipe tobacco, roll-your-own tobacco, cigarette papers or tubes, and processed tobacco reported in this inventory, and I
am satisfied that the inventory is accurate.
10. SIGNATURE OF TTB OFFICER

11. TITLE

TTB F 5220.3 (02/2010) PREVIOUS VERSIONS SUPERSEDED AND MAY NOT BE USED

12. DATE

INSTRUCTIONS
WHEN REQUIRED - Each export warehouse proprietor is

3. SPECIAL INVENTORY - To be made whenever required

required by regulation to make a true and accurate

by any TTB officer. If an inventory is made as of the

inventory at the time of commencing business, at the time

beginning of business on any day, that date must be

of concluding business, and at other times when required

entered as the DATE OF INVENTORY. If the inventory is

by the appropriate TTB officer (27 CFR Part 44). Such

made as of the close of business on any day, it will be

inventories must be made and the date entered in item 5 of

considered as made at the beginning of business of the

this form as the DATE OF INVENTORY as follows:

next calendar day, and that date must be entered as the

1. COMMENCING INVENTORY - To be made as of the date
of commencing business ( which will be t he effective date

DATE OF INVENTORY.
ITEMS TO BE INCLUDED - An inventory must include all

of the p ermit); at the time of transferring ownership; and at

tobacco products, cigarette papers, cigarette tubes, and

the time of changing location of the factory.

processed tobacco. Report quantities of chewing tobacco,

2. CONCLUDING INVENTORY - To be made as of the close

snuff, pipe tobacco, roll-your-own tobacco, and processed

of business on the date the business is concluded,

tobacco in pounds and fractions of a pound rounded to two

including transfer of ownership, and including a change of

decimal places.

location. If a fiduciary takes over the business for liquidation

PREPARATION AND DISPOSITION - The inventory must be

and files a statement and extension of coverage of the

prepared in duplicate by the proprietor. The original must

proprietor’s bond, as provided by regulation, no concluding

be submitted to the National Revenue Center, 550 Main St,

inventory is necessary until the fiduciary liquidates the

Ste 8002, Cincinnati. OH 45202-5215, and the duplicate

business. The DATE OF INVENTORY will be the date the

must be retained by the proprietor

permit is surrendered, or in the case of transfer of
ownership, the date preceding the change.

PAPERWORK REDUCTION ACT NOTICE
This request is in accordance with the Paperwork Reduction Act of 1995. The purpose of this information collection is to establish a
basis for verification of tax liability. This form is subject to TTB inspection. Completion of this form is mandatory (26 U.S.C. 5721 and
5741).
The estimated average burden associated with this collection of information is 5 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 DC 20220.
An agency may not conduct or sponsor, and an individual is not required to respond to, a collection of information unless it displays a
current, valid OMB control number.

TTB F 5220.3 (02/2010) PREVIOUS VERSIONS SUPERSEDED AND MAY NOT BE USED