TTB F 5130.23 Brewer's Bond Continuation Certificate

Brewer's Bond and Brewer's Bond Continuation Certificate; Brewer's Collateral Bond and Brewer's Collateral Bond Continuation Certificate

TTB F 5130.23 (08-2017)

Brewer's Bond Continuation Certificate

OMB: 1513-0015

Document [pdf]
Download: pdf | pdf
OMB No. 1513-0015
Please check one box. This bond covers a:

DEPARTMENT OF THE TREASURY

Brewery

ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)

BREWER’S BOND CONTINUATION CERTIFICATE

Pilot Brewing Plant

EIN:
(You must file two copies of this bond with original signatures.
D
Please see the instructions below)
What is your brewery’s legal name?
If your brewery is incorporated, a limited liability company, a partnership,
or a limited partnership, list the State of incorporation or organization.

What is your brewery’s mailing address?
(Number and Street)

(City)

( County)

(State)

(ZIP Code)

(City)

(County)

(State)

(ZIP Code)

What is the location of your brewery?
(Number and Street)

Enter Applicable Bonds and Continuation Certificates Below
TTB Form Number

Bond Amount

Effective Date

TTB Form Number

Effective Date

Bond Amount

$

$

$

$

$

$

$

$
Total Amount of this Continuation Certificate is: $

Effective Date of this Continuation Certificate:

Penalties of Perjury Statement
I, the brewery, agree to all terms and conditions of the bond as listed below. I further declare under penalties of perjury that the persons owning,
controlling, or actively participating in the management of the brewery
have
have never compromised or been convicted
in a court of competent jurisdiction of:
•

Any fraudulent noncompliance with any provision of law of the United States
• if it relates to internal revenue or customs taxation of distilled spirits, wines , or beer, or
• if the offense is compromised with the individual, firm, partnership, corporation , or association on payment of penalties or ot herwise;

OR
•

Any felony under a law of any State or the District of Columbia, or the United States, prohibiting the manufacture, sale, impo rtation, or
transportation of distilled spirits, wines, beer, or other intoxicating liquor.

We, the brewery and surety, witness our hands and seals this

day of

,

Signed, sealed, and delivered in the presence of-Brewery's Legal Name

Surety Company

Signature

Signature

Name and Title

Name and Title

BREWERY
SEAL

Signature of Two Witnesses
(on behalf of brewery)
ONLY if brewery has no Seal

SURETY
SEAL

Alcohol and Tobacco Tax and Trade Bureau - Approval and Acceptance
On behalf of the United States of America, I approve and accept this brewer’s bond continuation certificate.
This certificate continues the listed bonds and will expire on
Director, National Revenue Center
Alcohol and Tobacco Tax and Trade Bureau
TTB F 5130.23 (08/2017)

Date Approved

.

What is the purpose of this continuation certificate?
We, the brewery (as principal) and the surety (or sureties), promise ourselves to the United States of America for payment in the amount of th is bond
in lawful money of the United States. This bond firmly binds ourselves, together and individually, our heirs, executors, administrators, successors,
and assigns.
At the premises identified in this certificate I am now engaged in, or intend to continue to engage in:
•
the business of producing beer on the premises of the brewery; OR
•
the operation of a pilot brewing plant.
These are
are the
theterms
termsofofthis
this
certificate.
These
certificate.

1.

What is the certificate effective date?
•
The certificate is effective only if TTB agrees to accept it.
•
If TTB accepts this certificate it is effective without notice to us.
•
The certificate effective date is the date listed on the front of this form. The certificate will not in any case be effective before the date
shown. If no effective date is shown, the date this certificate is signed will be the effective date.

2.

When does this certificate expire?
•
This certificate expires with respect to the accrual of further liability four years from the effective date.
•
We may continue the certificate in force for additional, successive periods of four years by mutually agreeing to extend the certificate, with
a Brewer’s Bond Continuation Certificate, TTB F 5130.23. The certificate will continue in force only if TTB agrees to accept the
continuation certificate.
These are the conditions of this certificate.
Continuation of bond: We agree to continue in force the bonds and continuation certificates we list on the front of this certificate. We
continue these bonds subject to all provisions of law and regulations that apply to brewer’s bonds.

1.

2.

Liability: I, the brewery, must pay to the United States, according to the laws and regulations of the United States, the taxes on all bee r,
including penalties and interest, for which I become liable .
(a) Liability as a brewery: I am liable for taxes for all beer removed for consumption or sale, including beer I:
(1) transfer to this brewery from other breweries or pilot brewing plants I control;
(2) import in bulk and remove from Customs custody for transfer to my internal revenue bond;
(3) remove without payment of tax for export, for use as supplies on vessels or aircraft, or for transfer to and deposit in foreign-trade
zones for exportation, which is not exported or used as authorized;
(4) remove without payment of tax for laboratory analysis, or for authorized research, development or testing, of processes, systems, materials,
or equipment relating to beer or brewery operations;
(5) remove without payment of tax to any distilled spirits plant for use as distilling material;
(6) remove without payment of tax for use of foreign embassies, legations, etc.; and
(7) remove without payment of tax for destruction.
(b) Liability as a pilot brewing plant: As a pilot brewing plant operator, I am liable for taxes for all beer I brew, produce, or receive on
the pilot brewing plant.

3.

Faithful compliance: I must faithfully comply in all respects, without fraud or evasion, with all legal and regulatory requirements relating to the
production and sale of beer.

4.

Full obligation: This obligation remains in full force and effect until I fulfill my obligations under the laws and regulations.

5.

Changes while certificate is in effect: We, the brewery and the surety (or sureties), agree that all stipulations, covenants, and agreements of this
certificate extend and apply equally to any change in the business that requires a new or amended Brewer’s Notice for this brewery or pilot brewing
plant. This condition does not apply when the change is a change in the ownership of the business or in a change of location of the premises.

6.

We agree that TTB may grant the brewery an installment payment agreement for taxes, penalties, and interest. Installment agreements are
within the terms and conditions of the bond and do not affect TTB’s ability to pursue all available remedies against us under the bond.

7.

United States action if we breach any condition: On the breach of any of the conditions of this certificate, the United States may pursue
remedies against the brewer or surety (or sureties) independently, or against both jointly. The surety (or sureties) waives any right or privilege to

require that the United States must first start an action, intervene in any action already started, or otherwise exhaust its remedies, against

the brewer.

Paperwork Reduction Act Notice
This request is in accordance with The Paperwork Reduction Act of 1995. We use this information to determine whether you are q ualified to operate
as a brewer. We must identify you as the brewer, the surety company, and the bond amount. The information we request is requ ired for you to
obtain a benefit and is mandatory by law (26 U.S.C. 5401).
We estimate the average burden associated with this collection to be 45 minutes per brewer, depending on individual circumstanc es. Address your
comments concerning the accuracy of this burden estimate and suggestions to reduce this burden 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 you are not required to respond to, a collection of information unless it displays a current, valid OMB
control number.
TTB F 5130.23 (08/2017)

Privacy Act Information
We provide this information to comply with Section 3 of the Privacy Act of 1974 (5 U.S.C. 552a(e)(3)):
1.

What is TTB’s authority to ask for this information? We require this information under the authority of 26 U.S.C. 5401. You must disclose
this information to obtain authority to conduct brewing operations.

2.

What is the purpose for this information collection? You provide this information to give us a bond for your compliance with requirements
to establish a brewery, so that we may identify you as a brewer, and to identify your collateral for a brewer’s bond.

3.

How does TTB use this information? We use this information to make determinations for the purposes described in paragraph 2.
Also, we may disclose the information to other Federal, State, foreign, and local law enforcement and regulatory agency personnel to verify
information on the form where such disclosure is not prohibited by law. We may disclose the information to the Justice Department if it appears
that the furnishing of false information may constitute a violation of Federal law. Finally, we may disclose the information to members of the
public in order to verify information on the form where such disclosure is not prohibited by law.

4.

What is the effect of my not supplying the information TTB requests? If you fail to supply complete information then we will delay
processing and may disapprove or deny your application.
Brewer’s Bond Continuation Certificate — Instructions

1.

Where can I get assistance?
For help with this form, you may call us toll-free at 1-877-882-3277.

2.

Sign both copies with original signatures and either impress your brewery seal OR have two witnesses sign (see Instruction 12)

3.

Why must I submit two copies with original signatures?
If we accept your continuation certificate, we will keep one copy in our files and return the duplicate copy to you for your records. Both copies
must have original signatures. This certificate must be signed by someone who has authority to sign documents submitted to this Bureau on
behalf of the brewery.

4.

Where do I send this certificate?
Send both signed copies with all necessary attachments to:
Director, National Revenue Center
Alcohol and Tobacco Tax and Trade Bureau
550 Main St, Ste 8002
Cincinnati, OH 45202-5215

5.

What is an EIN?
EIN stands for Employer Identification Number. We use your EIN to identify your brewery in our registry and tax systems.
If you do not have an EIN, you must obtain one from the Internal Revenue Service (IRS). Use an IRS Form SS-4 and follow instru ctions
on the form to apply for an EIN.

6.

How do I identify the former bonds and certificates this agreement continues?
You must list each of the applicable bonds and continuation certificates that you continue with this agreement. Start with the original bond,
then list each bond or certificate continued thereafter.

7.

How do I determine the certificate amount?
The certificate amount is the sum of all of the bond amounts that you continue with this agreement. You may not change your to tal bond
amount with the continuation certificate. The total bond amount must remain the same. To change bond amounts you must file a new bond.
Please see 27 CFR Part 25 to determine the appropriate bond amount, or call us toll-free at 1-877-882-3277 for assistance.

8.

What do I list for “brewery’s name” and who signs this certificate for me?
Brewery Name and Signature
If the brewery is...

Then your brewery’s name on the certificate
must include...

And...

An Individual Owner as a Sole
Proprietorship

The full given name of the individual

The individual Or an empowered attorney-in-fact
must sign the certificate (see item 8) .

A Partnership

• Your firm's name, followed by
• The names of all its partners

A Limited Partnership (LP)

• Your Limited Partnership's name

Each partner must sign Or an authorized partner
must sign Or an empowered attorney-in-fact must
sign the certificate.
The person who is authorized to sign for the limited
partnership must give his/her signature and title AND
the limited partnership’s seal must be affixed. If there
is no seal, two witnesses must sign the certificate.

A Corporation or Limited Liability
Company (LLC)

• Your Corporate or LLC name
• The name of the State of Incorporation or
organization
•

9.

The person authorized to act for the corporation or LLC
must give his/her signature and title AND the brewery
seal must be affixed. If there is no seal, two witnesses
must sign the certificate.

Who may sign for a partnership, corporation or LLC?
The person signing on behalf of the brewery must have current signing authority or a Power of Attorney on file with this office.
p

9
TTB F 5130.23 (08/2008)

10. Who signs for the surety company?
Authorized persons sign for the surety, attested under the surety's seal. A Power of Attorney for the person signing on behalf of the surety
must be attached to both copies of the certificate.
11. Do I need witness signatures if I have a corporate seal?
If your brewery has obtained a seal, it must be impressed on both copies of the certificate. If your brewery has no seal, the signature
for the brewery must be made in the presence of two persons who will sign their names as witnesses.
12. Do I need to give an explanation if I have an affirmative answer in the Penalties of Perjury Statement?
Yes, under the provisions of 27 CFR 25.91(c), in the event the statement contains an affirmative answer, you must submit a statement
describing in detail the circumstances surrounding the conviction or compromise.
13. How do I make corrections to the certificate if I make a mistake?
Where you make any alteration or erasure in the certificate, you must incorporate a statement consenting to the alteration. You must add
this statement in the side margin of the certificate. Both the person signing for the brewery and surety must initial the statement:

and surety

We consent to all corrections made to this certificate : brewery

(Initials)

(Initials)

14. What if I download this form from the Internet and I cannot print both sides on one page?
We prefer that the certificate be on a single sheet. However, if you cannot print both sides on one sheet, you may print two pages.

77%)17


File Typeapplication/pdf
File TitleTTB F 5130-23
SubjectTTB F 5130-23
AuthorCathy Cassity
File Modified2017-08-17
File Created2004-05-14

© 2024 OMB.report | Privacy Policy