TTB F 5120.17sm Report of Wine Premises Operations (Smart Form)

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OMB No. 1513-0053

DEPARTMENT OF THE TREASURY

ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)

REPORT OF WINE PREMISES OPERATIONS
OPERATED BY (Name, Address, and Telephone)

PERIOD COVERED (Year Only, or Year & Month, or Year & Quarter)
YEAR

MONTH

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QUARTERLY:

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January to March

July to September

April to June

October to December

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VERSION (Select Original or Amended. Select Final if this is the last report for the business) EIN
REGISTRY NUMBER

Final Report
Amended
___Original
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INSTRUCTIONS
3. Explain any unusual operations in Part X.

1. The reporting period for this form must be monthly, except that proprietors who qualify under
the exception stated in 27 CFR 24.300(g)(2) may file this form on a quarterly or calendar year
basis unless required to file monthly by the Alcohol and Tobacco Tax and Trade Bureau (TTB).
A proprietor who files monthly reports but does not expect any reportable operations in a
subsequent month or months may indicate in Part X that no monthly reports will be filed until a
reportable operation occurs (§ 24.300(g)(1)).
2. Prepare this form in duplicate and file it by the fifteenth day after the end of the report period
( month, quarter, or year). Keep the copy on your bonded wine premises for inspection by TTB
officers. Send the original to TTB at this address: Director, National Revenue Center, Alcohol and
Tobacco Tax and Trade Bureau, 550 Main St, Ste 8002, Cincinnati, OH 45202-5215.

4. The quantities "on hand end" will ordinarily be "book inventory" figures, that is the quantity
required to balance each summary. Use the "on hand end" from your report for the previous period
as the "on hand beginning" of the current report. On reports for any period when you take a
physical inventory, report the difference as losses for bulk wine and shortages for bottled wine, or as
gains, as the case may be.
5. If the quantity of wine previously reported on TTB F 5120.17 is affected by adjustments made on
a tax return, TTB F 5000.24, adjust the current TTB F 5120.17 in Section A (and Section B, if
bottled wine is involved). Explain the entries in Part X.

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PART I - SUMMARY OF WINES IN BOND (GALLONS)

ALCOHOL CONTENT BY VOLUME
NOT OVER 14
PERCENT
(a)

ITEM

1.

SECTION A - BULK WINES
ON HAND BEGINNING OF PERIOD

2.

PRODUCED BY FERMENTATION1/

3.

PRODUCED BY SWEETENING

4.
5.
6.

PRODUCED BY ADDITION OF WINE SPIRITS
PRODUCED BY BLENDING
PRODUCED BY AMELIORATION

7.
8.
9.

RECEIVED IN BOND
BOTTLED WINE DUMPED TO BULK
INVENTORY GAINS

OVER 14 TO 21 PERCENT OVER 21 TO 24 PERCENT
(Inclusive)
(Inclusive)
(b)
(c)

ARTIFICIALLY
CARBONATED
WINE
(d)

SPARKLING WINE
(e)

HARD CIDER
(f)

BF
BP

10.
11.
TOTAL

12.

0.00

0.00

0.00

0.00

0.00

0.00

0.00

BF
BP

13. BOTTLED2/
14. REMOVED TAXPAID
15.
16.
17.
18.

0.00

TRANSFERS IN BOND
REMOVED FOR DISTILLING MATERIAL
REMOVED TO VINEGAR PLANT
USED FOR SWEETENING

19. USED FOR ADDITION OF WINE SPIRITS
20. USED FOR BLENDING4/
21. USED FOR AMELIORATION
22. USED FOR EFFERVESCENT WINE
23. USED FOR TESTING
24.
25.
26.
27.
28.
29. LOSSES (OTHER THAN INVENTORY)
30. INVENTORY LOSSES
31. ON HAND END OF PERIOD
TOTAL

32.
1.
2.

0.00

0.00

0.00

0.00

SECTION B - BOTTLED WINES
ON HAND BEGINNING OF PERIOD
BOTTLED2/

BF
BP

3.
4.
5.
6.

RECEIVED IN BOND
TAXPAID WINE RETURNED TO BOND

7.
8.

REMOVED TAXPAID

9.
10.
11.
12.

TRANSFERRED IN BOND
DUMPED TO BULK
USED FOR TASTING
REMOVED FOR EXPORT

TOTAL

0.00

0.00

0.00

0.00

0.00

0.00

TOTAL

0.00

0.00

0.00

0.00

0.00

0.00

13