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pdfOMB No. 1513-0135 (xx-xx-xxxx)
DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU
CONTINUING EXPORT BOND – DISTILLED SPIRITS AND WINE
(File in duplicate. See instruction below)
1.
PRINCIPAL/OBLIGOR (See instructions 2, 3, and 4) 2.
3.
KIND OF BOND (Check only one)
4.
TYPE OF BOND
SURETY
7.
ADDRESS OF BUSINESS OFFICE (Number, street, city, State, ZIP Code)
ORIGINAL
COLLATERAL:
Cash
STRENGTHENING
SUPERSEDING
5.
CHECK NUMBER
6.
8.
AMOUNT OF BOND
CUSIP NUMBER/MATURITY DATE
Treasury Note/Bond
SURETY NAME
9.
EFFECTIVE DATE
KNOW ALL MEN BY THESE PRESENT, That we, the above named principal/obligor and surety, bind ourselves, our heirs, executors, administrators, successors,
and assigns, jointly and severally, unto the United States of America for the payment of the above amount, in lawful money of the United States.
WHEREAS, the principal/obligor 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 exportation from the United States, or for use on vessels or aircraft, or for transfer to and deposit in a foreign trade
zone, or for transfer to and deposit in a customs bonded warehouse:
Now, Therefore, the conditions of this bond are :___________________________________________________________________________________________.
If the Principal/Obligor does not:
1. Faithfully comply with all the requirements of law and regulations pertaining to all distilled spirits and/or wines withdrawn from the bonded premises without
payment of tax for exportation, or for use on vessels or aircraft, or for transfer to foreign-trade zone or for transfer to a customs bonded warehouse; and such
distilled spirits or wines, or any part thereof are not exported, used or transferred, or otherwise lawfully disposed of or accounted for,
2. Or if the principal/obligor does not pay to the United States the tax imposed by law now or hereafter in force, together with penalties if any, and interest
Then the surety (or sureties) is obligated to pay to the United States the tax imposed by law now or hereafter in force, together with penalties if any, and interest.
10. 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 premise, the principal/obligor will, (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 distilled spirits coverage, designate the premises at which the account with the bond is to be maintained, or allocate to
each premise the amount of bond coverage. If this space is insufficient, attach appropriately identified rider.
Plant Name
Plant Kind
Plant/ Registry
Number
Address
Distilled Spirits
Coverage
Wine Coverage
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/obligor 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 will first commence action, intervene in any action of
any nature whatsoever already commenced, or otherwise exhaust its remedies, against the principal/obligor.
11. BOND EXECUTION
Witness our hands and seals this
day of
SURETY NAME
, 20
. Signed, sealed and delivered in the presence of --
PRINCIPAL/OBLIGOR NAME
BY:
PRINCIPAL/OBLIGOR REPRESENTATIVE’S SIGNATURE
SURETY REPRESENTATIVE SIGNATURE
PRINCIPAL/OBLIGOR REPRESENTATIVE’S PRINTED NAME/TITLE
SURETY REPRESENTATIVE PRINTED NAME & TITLE
SIGNATURE, WITNESS 1 (If no seal)
Impress
Surety
Seal
Alterations made on this
bond before and after
execution were made
with the consent of the
Principal ______ and
CORPORATIONS/PARTNERSHIPS, OR LLC SEALS
State in which Principal/Obligor organized:
Impress Principal/Obligor’s corporate or LLC seal or select
the checkbox below
Surety ______ OR
Obligor ______.
TTB F 5100.30 (03/2018)
SIGNATURE, WITNESS 2 (If no seal)
The corporation/LLC has no seal.
Principal/
Obligor
Seal
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
law, regulations, and instructions.
SIGNATURE
DATE APPROVED
DIRECTOR, NATIONAL REVENUE CENTER, ALCOHOL AND TOBACCO TAX AND TRADE BUREAU
INSTRUCTIONS
1. This bond must be filed in duplicate with the Director,
corporation, must also be so attested if the corporation has a
National Revenue Center, Alcohol and Tobacco Tax and Trade corporate seal. If the corporation has no seal, select the check
box in Item 11. Each signature must be made in the presence
Bureau, 550 Main Street, Ste. 8002, Cincinnati, OH
of two witnesses (except where corporate seal are affixed),
45202-5215.
who must sign their names as such.
2. The name, including the full given name, of each party to
7. A bond may be given with corporate surety authorized to
the bond must be written in the heading thereof, and each party
act
as surety by the Secretary of the Treasury, or by deposit of
must sign the bond with his/her signature, or the bond may be
collateral
security. Lists of approved surety companies and
executed in his/her name by a duly empowered attorney-insecurities
acceptable as collateral is available from the Bureau
fact.
of the Fiscal Service at https://www.fiscal.treasury.gov.
3. In the case of a partnership, the duly authorized trade
TREASURY COLLATERAL BONDS: If this bond is filed as a
name of the firm, followed by the names of all the members
collateral bond secured by a Treasury Note or Bond in an
thereof, must be given in the heading. In executing the bond,
approved Department of Treasury holding account, this bond is
the firm name must be typed or written followed by the word
secured by the Treasury collateral identified on the face of the
“by” and the usual signatures of all partners, or the signature of
bond and any Treasury collateral resulting from roll-over of the
any partner duly authorized to sign the bond on behalf of the
previous Treasury collateral. The Treasury collateral identified
firm, or by a duly empowered attorney-in-fact.
in this bond will automatically roll over upon maturity unless the
4. If the principal/obligor is a corporation, the heading must
obligor notifies the National Revenue Center at least 45 days
give the corporate name, the name of the State under the laws prior to maturity.
of which it is organized, and the location of the principal/obligor
8. If any alteration or erasure is made in any bond before the
office; and the bond must be executed in the corporate name,
execution thereof, there must be incorporated in the bond a
immediately followed by the signature and title of the person
statement to that effect by the principal/obligor and surety or
duly authorized to act in its behalf.
sureties; or if such alternation or erasure was made after the
5. If the bond is signed by an attorney-in-fact, or by one of
bond was executed, the consent of all parties thereto must be
the members for a partnership or association, or by an officer
written in the bond. (See Item 11.)
or other person for a corporation, there must be filed with the
9. The penal sum named in the bond must be in accordance
bond a duly authenticated copy of the power of attorney,
with
27 CFR Part 28.
resolution of the board of directors, excerpt of the bylaws, or
other documents, authorizing the person signing the bond to
10. After approval of the bond, a copy must be returned to the
execute it on behalf of the principal/obligor, unless such
principal/obligor.
authorization has been previously filed with the Director,
11. This bond will not in any case be effective before the
National Revenue Center, Alcohol and Tobacco Tax and Trade
Effective Date shown in Item 9, but if accepted by the United
Bureau, in which event a statement to such effect must be
States it will be effective according to its terms on and after that
attached to the bond.
date without notice to the obligors: Provided, That if no effective
6. The signature for the surety must be attested under
date is inserted in the space provided, the date of execution will
corporate seal. The signature for the principal/obligor, if a
be the effective date of the bond.
PAPERWORK REDUCTION ACT NOTICE
This request is in accordance with the Paperwork Reduction Act of 1995. The information is used by the proprietor, or the proprietor
and a surety company, as a contract to ensure tax payment. The information requested is required to obtain a benefit and is
mandatory by statute (26 U.S.C. 5175, 5214, 5362).
The estimated average burden associated with this collection of information is 1 hour 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,
1310 G Street, NW., Box 12, Washington, DC 20005.
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 5100.30 (03/2018)
File Type | application/pdf |
Author | TTB |
File Modified | 2018-02-27 |
File Created | 2010-11-24 |