Form TTB F 5110.28 TTB F 5110.28 Monthly Report of Processing Operations

DEPARTMENT OF THE TREASURY

OMB No. 1513-0041 (11/30/2010)
2. MONTH AND YEAR

1. PLANT NUMBER

ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)

MONTHLY REPORT OF PROCESSING OPERATIONS
1. Every proprietor engaged in processing operations must prepare this form each month in duplicate.
2. The proprietor must forward the original to the Director, National Revenue Center, on or before the 15th day of the month
following the month for which prepared.
3. The copy is to be kept on file by the proprietor.

3. NAME OF PROPRIETOR

5. Employer Identification Number (EIN)

4. LOCATION OF PLANT
PART I - BULK INGREDIENTS

PART II - FINISHED PRODUCTS

TRANSACTION

WINE
(Proof gallons)

SPIRITS
(Proof gallons)

(a)

(b)

(c)

1.
2.
3.

ON HAND FIRST OF MONTH
RECEIVED (Other than line 3)
ALCOHOL FOR FUEL USE RECEIVED FROM
CUSTOMS CUSTODY

4.
5.
6.

ALCOHOL, FLAVOR, MATERIALS DUMPED
WINE MIXED WITH SPIRITS
DUMPED FOR FURTHER PROCESSING

7.

GAINS

8.

TOTAL - LINES 1 THROUGH 7

9.

BOTTLED OR PACKAGED

10.
11.
12.
13.
14.

WINE MIXED WITH SPIRITS
USED FOR DENATURATION
TRANSFERRED IN BOND
WITHDRAWN TAX DETERMINED
WITHDRAWN FREE OF TAX: FOR U.S., HOSPITAL,
SCIENTIFIC, OR EDUCATIONAL USE

TRANSACTION
(a)
27.
28.
29.
30.

BOTTLED
(Proof gallons)
(b)

PACKAGED
(Proof gallons)
(c)

ON HAND FIRST OF MONTH
BOTTLED OR PACKAGED
RECEIVED
INVENTORY OVERAGES

31. TOTAL - LINES 27 THROUGH 30
1

32. TRANSFERRED IN BOND
33. WITHDRAWN TAX DETERMINED
34. WITHDRAWN FREE OF TAX: FOR U.S. HOSPITAL,
SCIENTIFIC, OR EDUCATIONAL USE
35. WITHDRAWN WITHOUT PAYMENT OF TAX:
FOR ADDITION TO WINE
36. FOR EXPORTATION, VESSELS, AND AIRCRAFT,
AND TRANSFER TO C.B.W.
37. TRANSFERRED TO PRODUCTION ACCOUNT
FOR REDISTILLATION

15. WITHDRAWN WITHOUT PAYMENT OF TAX:
FOR ADDITION TO WINE

38. WITHDRAWN FOR RESEARCH, DEVELOPMENT,
OR TESTING (Including Gov. samples)

16. FOR EXPORTATION & TRANSFER TO C.B.W.
17. TRANSFERRED TO PRODUCTION ACCOUNT
FOR REDISTILLATION

39. DESTROYED
40. DUMPED FOR FURTHER PROCESSING
41.

18. WITHDRAWN FOR RESEARCH, DEVELOPMENT,
OR TESTING (Including Gov. samples)

42.
43.

19. DESTROYED
20. USED FOR REDISTILLATION
21.
22.
23.

44. RECORDED LOSSES
45. INVENTORY SHORTAGES
46. ON HAND END OF MONTH
47. TOTAL - LINES 32 THROUGH 46

24. LOSSES
25. ON HAND END OF MONTH
26. TOTAL - LINES 9 THROUGH 25
TTB F 5110.28 (/2)

1

Bottled nonindustrial (beverage) use spirits may not be received or transferred in bond.

PART III - PUERTO RICAN AND VIRGIN ISLANDS SPIRITS (RUM) AND "OTHER" IMPORTED RUM1
48. PROOF GALLONS REMOVED TAXPAID OR TAX DETERMINED (27 CFR 19.778)

(a) PUERTO RICAN SPIRITS

(b) VIRGIN ISLANDS SPIRITS

(c) "OTHER" IMPORTED RUM

PART IV - PROCESSING OF BEVERAGE (Nonindustrial use) SPIRITS

PART IV – PROCESSING OF BEVERAGE (Nonindustrial use) SPIRITS
KIND

(a)

BULK SPIRITS DUMPED
INTO PROCESSING2
(Whole proof gallons)

BOTTLED - IMPORTED3

(b)

(c)

(Whole proof gallons)

BOTTLED
(Excluded bottled in bond
and export)
(Whole wine gallons)
(d)

BOTTLED IN BOND4
27 CFR 5.42(b)
(Exclude export)
(Whole wine gallons)
(e)

BOTTLED
FOR EXPORT
(Whole wine gallons)
(f)

49. ALCOHOL AND NEUTRAL SPIRITS (Other than vodka)
50. BLENDED STRAIGHT WHISKEY5
51. BLENDED WHISKEY:

a.
b.

With neutral spirits6
With light whiskey7

52. BLENDED LIGHT WHISKEY8
53. ANY OTHER BLENDS OF 100% WHISKEY
a. Scotch
54. IMPORTED WHISKEY: b. Canadian
c. Irish and Others
55. DOMESTIC WHISKEY DISTILLED AT 160° AND UNDER
56. DOMESTIC WHISKEY DISTILLED AT OVER 160°
57. BRANDY DISTILLED AT 170° AND UNDER
58. BRANDY DISTILLED AT OVER 170°
59. SPIRITS (Rum)1
60. RUM

a.

Puerto Rican

1b. Virgin Islands
a. Domestic
b.

"Other" Imported

61. GIN
62.
63.
64.
65.

VODKA
CORDIALS, LIQUEURS, AND SPECIALTIES9
COCKTAILS AND MIXED DRINKS
TEQUILA

66.
67. TOTAL - LINES 49 THROUGH 66
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 and complete report.
DATE
PROPRIETOR
BY (Signature and Title)
Only products containing at least 92% RUM should be recorded at line 48(a) and (b), and at lines 59
a and b.
2
Do not include spirits that have been previously reported as dumped on dump/batch records and
retained in processing (27 CFR 19.373(b)(2).)
3
Include spirits from Puerto Rico and Virgin Islands. Imported spirits that are not allowed to be
labeled as a product of a foreign country, Puerto Rican, or Virgin Islands spirits under 27 CFR Part 5
must be reported as domestic spirits.
1

Bottled in bond spirits are those that conform to the standard prescribed by 27 CFR 5.42(b) and are
labeled with the words "bond," "bottled in bond," "aged in bond," or similar phrases. Do not include
imported spirits.
5
Blends of straight whiskies, all of which are 2 years old or older; no neutral spirits; no light whiskey.
6
Blended whiskey, containing at least 20% straight whiskey, and the balance, neutral spirits.
7
Blended whiskey containing at least 20% straight whiskey, and the balance, light whiskey.
8
Light whiskey blended with more than 2% but less than 20% straight whiskey; no neutral spirits.
9
Includes flavored whiskies, gins, vodkas, brandies, etc.
4

TTB F 5110.28 (/20)

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 operation of
industries regulated by TTB. The information is required to verify unusual activities, errors, and omissions on taxable commodities. The information 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 repond to, a collection of information unless it displays a current, valid OMB control
number.

TTB F 5110.28 (0/20)