Form TTB F 5110.40 TTB F 5110.40 Monthly Report of Production Operations

1. NAME OF PROPRIETOR

DEPARTMENT OF THE TREASURY

OMB No.
No. 1513-0047
1513-0047 (09/30/2009)
(11/30/2012)
OMB
3. MONTH AND YEAR

2. EIN

ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)

MONTHLY REPORT OF PRODUCTION OPERATIONS

5. PLANT NUMBER
DSP

4. LOCATION OF PLANT

(PREPAREIN
INDUPLICATE,EE
DUPLICATE. SEE
INSTRUCTIONS
BELOW)
(PREPARE
INSTRUCTIONS
BELOW)
PART I - TRANSACTIONS
PROOF GALLONS
WHISKY

WITHDRAWN FOR

TRANSACTION
(a)

160° AND UNDER
(b)

1.

TAX PAYMENT

2.
3.
4.
5.
6.
7.

USE OF U.S.
HOSPITAL, SCIENTIFIC, OR EDUCATIONAL USE 1
EXPORT
TRANSFER TO FOREIGN TRADE ZONE
TRANSFER TO CMBW
USE AS SUPPLIES ON VESSELS OR AIRCRAFT

8.
9.
10.
11.

USE IN WINE PRODUCTION
ENTERED IN PROCESSING ACCOUNT
ENTERED FOR TRANSFER IN BOND
ENTERED IN STORAGE ACCOUNT

OVER 160°
(c)

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

RUM
(f)

VODKA
(h)

GIN
(g)

ALCOHOL AND SPIRITS
UNDER 190°
190° AND OVER
(Distillation Proof)
(i)

(Distillation Proof)
(j)

OTHER
(Identify)
(k)

TOTAL
(l)

12. WITHDRAWN FOR RESEARCH, DEVELOPMENT,
OR TESTING2
13.
14. PRODUCED (Total, Lines 1 through 13)
15. RECEIVED FOR REDISTILLATION 3
16.

4

17. PHYSICAL INVENTORY- (a) RECEIVED FOR
END OF CALENDAR
REDISTILLATION3
QUARTER
(b) UNFINISHED SPIRITS
PART II - PRODUCTION OF ALCOHOL AND
SPIRITS OF 190° OR MORE OF PROOF,
BY KIND OF MATERIAL USED
KIND OF MATERIAL
(a)

PROOF GALLONS
(b)

PART III - PRODUCTION OF WHISKY BY KIND AND COOPERAGE USED
PROOF GALLONS
NEW COOPERAGE
(b)

KIND
(a)

PROOF GALLONS
USED COOPERAGE
(c)

PROOF GALLONS
DEPOSITED IN TANKS
(d)

PART IV - PRODUCTION OF BRANDY BY KIND

PART V - USED IN REDISTILLATION

PROOF GALLON
(b)

KIND
(a)

KIND OF SPIRITS 5
(a)

1. GRAIN
2. FRUIT
3. MOLASSES

1. BOURBON
2. CORN
3. RYE

1. GRAPE BRANDY
2. ALL OTHER BRANDY
3. NEUTRAL GRAPE BRANDY

1.
2.
3.

4.
5.
6.
7.
8.

4. LIGHT
5.
6.
7.
8.

4. ALL OTHER NEUTRAL BRANDY
5.
6.
7.
8.

4.
5.
6.
7.
8.

ETHYL SULFATE
ETHYLENE GAS
SULPHITE LIQUORS
FROM REDISTILLATION

Does not include spirits withdrawn for experimental or research use under 26 U.S.C.
5312; report these at line 12.
2
Show withdrawals under 26 U.S.C. 5214(a)(10), 5373(b)(4) , or 5312.
1

TTB F 5110.40 (01/2010)
(01/20)

3

Does not include recovered denatured spirits or articles returned for restoration and/or denaturation under
27 CFR 19.683; such materials should be reported on TTB F 5110.43, Monthly Report of Processing (Denaturing)
Operations. Imported spirits received for redistillation will be identified as such and reported separately in Parts II and V .

4
5

Samples returned must be shown here.
If alcohol or spirits, indicate whether "190 ° or over"
or "under 190°".

PROOF GALLON
(b)

PART VI - MATERIALS USED

USED IN PRODUCTION
OF DISTILLED SPIRITS

KIND

POUNDS
(b)

(a)

GALLONS
(c)

USED IN MANUFACTURE
OF SUBSTANCES OTHER
THAN DISTILLED SPIRITS, IN
PROCESSES YIELDING DISTILLED
SPIRITS AS A BY-PRODUCT
POUNDS
GALLONS
(d)
(e)

GRAIN AND GRAIN PRODUCTS
1.

CORN

2.

RYE

3.

MALT

4.

WHEAT

5.

SORGHUM GRAIN

6.

BARLEY

7.
8.
FRUIT AND FRUIT PRODUCTS
9.

GRAPE

10.
11.
12.
13.
14.
CANE AND CANE PRODUCTS
15. MOLASSES
16.
17.
18.
OTHER MATERIALS
19. ETHYL SULFATE
20. ETHYLENE GAS
21. SULPHITE LIQUORS
22. BUTANE GAS
23.
Under penalties of perjury, I declare that I have examined this report, and to the best of my knowledge and belief, it is true, correct, and complete and is
supported by true, correct, and complete commercial records which are available for inspection.

DATE

PROPRIETOR

BY (Signature and title)

INSTRUCTIONS
Every proprietor of a distilled spirits plant 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. The remaining copy must be retained by the proprietor.

PAPERWORK REDUCTION ACT NOTICE
This information collection 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, and omissions on taxable
commodities. The information is mandatory by statue (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 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 5110.40 (01/2010)