Form TTB F 5110.67 TTB F 5110.67 Continuing Transportation Bond - Distilled Spirits and W

Specific and Continuing Transportation Bond - Distilled Spirits or Wines Withdrawn for Transportation to Manufacturing Bonded Warehouse - Class Six

TTB F 5110.67 (2010)

Continuing Transportation Bond - Distilled Spirits and Wines Withdrawn for Transportation to Manufacturing Bonded Warehouse - Class Six

OMB: 1513-0031

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OMB No. 1513-0031 (03/31/2013)
DEPARTMENT OF THE TREASURY - ALCOHOL AND TOBACCO TAX AND TRADE BUREAU

CONTINUING TRANSPORTATION BOND - DISTILLED SPIRITS AND WINES WITHDRAWN FOR
TRANSPORTATION TO MANUFACTURING BONDED WAREHOUSE - CLASS SIX
(File in duplicate. See instructions on page 2.)

PRINCIPAL (See instructions 2, 3, and 4)

BUSINESS OFFICE ADDRESS (Number, street, city, State, and ZIP code)

SURETY (or SURETIES)

WAREHOUSE NUMBER

AMOUNT OF BOND

EFFECTIVE DATE

LOCATION OF WAREHOUSE (Number, street, city, State, and ZIP code)

KNOW ALL MEN BY THESE PRESENTS, that we the above-named principal and surety (or sureties) are held and firmly bound unto the United States
of America in the above-named amount, lawful money of the United States; for the payment of which we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents.
The bond will not in any case be effective before the above-named date, but if accepted by the United States it will be effective according to its terms
on and after that date without notice to the obligors: provided, that if no date is inserted in the space above provided therefore, the date of execution
hereof will be the effective date.
WHEREAS, the principal is the proprietor of the Manufacturing Bonded Warehouse, Class Six, described above, established and bonded under the
provisions of Chapter 51 of Title 26 of the United States Code and of the Tariff Act of 1930, as amended; and
WHEREAS, the principal intends to withdraw from time to time from the distilled spirits plants and/or bonded wine cellars herein specified, certain
distilled spirits and/or wines, without payment of tax, for transportation to and deposit in the Manufacturing Bonded Warehouse:
(List below the name, kind of plant, plant or registry number, and address of each distilled spirits plant and/or bonded wine cellar from which withdrawals are to be made.) Where this bond is given in less than the maximum penal sum to cover withdrawals from more than one premises, the principal
must, (1) if he intends to withdraw both distilled spirits and wines, apportion the coverage between distilled spirits and wines, and (2) when distilled
spirits are to be withdrawn from more than one premises, as to the distilled spirits coverage, designate the premises at which the account with the bond is
to be maintained, or allocate to each premises the amount of bond coverage.)

(Use space below or attach a separate sheet if necessary)
NOW, THEREFORE, the conditions of this bond are such that —
1.

If the distilled spirits and/or wines so withdrawn are duly transported to and deposited in the manufacturing bonded warehouse aforesaid, as required
by law and regulations; and

2.

If the principal has, as to such distilled spirits and/or wines, or any part thereof, not so transported and deposited, or otherwise lawfully disposed
of or accounted for, paid to the United States the tax imposed thereonby law now or hereafter in force, together with penalties and interest;

Then this obligation is to be null and void, but otherwise to remain in full force and effect.
We, the obligors, for ourselves, our heirs, executors, administrators, successors, and assigns, do further covenant and agree that upon the breach of any of
the covenants of this bond, the United States may pursue its remedies against the principal or surety independently, or against both jointly, and the said
surety hereby waives any right or privilege it may have of requiring, upon notice, or otherwise, that the United States must first commence action, intervene in any action of any nature whatsoever already commenced, or otherwise exhaust its remedies against the principal.
WITNESS our hands and seals this

day of

, 20

Signed, sealed, and delivered in the presence of —

SEAL
SEAL
SEAL
SEAL
SEAL
SEAL
KIND OF BOND (Check applicable item)
item)

TTB F 5110.67 (04/2010)

___ STRENGTHENING

___ ORIGINAL

Page 1 of 2

___ SUPERSEDING

FOR TTB USE ONLY
On behalf of the United States, I approve the foregoing bond which has been executed in due form and in compliance with the applicable law, regulations, and instructions.
SIGNATURE OF DIRECTOR, NATIONAL REVENUE CENTER, ALCOHOL AND TOBACCO
TAX AND TRADE BUREAU

DATE APPROVED

INSTRUCTIONS
1. This bond must be filed in duplicate with the Director, National
Revenue Center, Alcohol and Tobacco Tax and Trade Bureau, 550 Main
St., Ste 8002, Cincinnati, OH 45202-5215, for the bonded premises from
which the liquors are to be withdrawn.
2. The name, including the full given name, of each party to the
bond must be given in the heading, and each such party must sign the
bond with his/her signature, or the bond may be executed in his/her
name by a duly empowered attorney-in-fact.
3. In the case of a partnership, the trade name of the firm, followed
by the names of all the members thereof, must be given in the heading.
In executing the bond the firm name must be typed or written followed
by the word "by" and the usual signatures of all partners, or the
signature of any partner duly authorized to sign the bond in behalf of
the firm, or by a duly empowered attorney-in-fact.
4.
If the principal is a corporation, the heading must give the corporate name, the name of the State under the laws of which it is organized, and the location of the principal office. The bond must be
executed in the corporate name, immediately followed by the signature
and title of the person duly authorized to act for the corporation.
5.
If a bond is signed by an attorney-in-fact for the principal, or by
one of the members for a partnership or association, or by an officer
or other person for a corporation, there must be filed with the bond a
duly authenticated copy of the power of attorney, resolution of the
board of directors, excerpt of the bylaws, or other document, authorizing the person signing the bond to execute it on behalf of the principal, unless such authorization has been previously filed with the
Director, National Revenue Center, Alcohol and Tobacco Tax and
Trade Bureau, in which event a statement to such effect must be
attached to the bond.

6. The signature for the surety must be attested under corporate seal.
The signature for the principal, if a corporation, must also be so attested
if the corporation has a corporate seal; if the corporation has no seal
that fact should be stated. Each signature must be made in the presence
of two witnesses (except where corporate seals are affixed), who must
sign their names as such.
7. A bond may be given with corporate surety authorized to act as
surety by the Secretary of the Treasury, or by deposit of collateral
security. Only public debt obligations of the Untied States, the principal
and interest of which are unconditionally guaranteed by the United
States Government, are acceptable as collateral security (31 U.S.C.
9301, 9303). A list of securities acceptable as collateral in lieu of surety
bonds is available from the Bureau of the Public Debt, Office of the
Commissioner, Government Securities Regulations Staff.
8.
If any alteration or erasure is made in any bond before its execution there must be incorporated in the bond a statement to that effect
by the principal and surety or sureties; or if such alteration or erasure
was made after the bond was executed, the consent of all parties thereto must be written in the bond.
9. The penal sum named in the bond must be in accordance with
27 CFR Part 28.
10. If the bond is approved, a copy will be returned to the principal.
11. All correspondence about the filing of this form or any subsequent
action, including termination, affecting this bond should be addressed to the
Director, National Revenue Center, Alcohol and Tobacco Tax and Trade
Bureau, with whom the bond is filed. The record retention period is 2 years.

PAPERWORK REDUCTION ACT NOTICE
This request is in accordance with the Paperwork Reduction Act of 1995. The purpose of this information collection is to protect Federal excise taxes.
The information is used to determine compliance by payment on taxpaid commodities. The information requested is mandatory by Statute (19 U.S.C. 1311).
The estimated average burden associated with this collection of information is 1 hour per respondent or recordkeeper depending on individual circumstances.
Comments on 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.

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TTB F 5110.67 (04/2010)


File Typeapplication/pdf
AuthorTTB
File Modified2010-05-18
File Created2005-05-12

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