TTB Form 5200.16 "Application for Amended Permit to Manufacture Tobacco Products or Processed Tobacco or to Operate an Export Warehouse"

What Is TTB Form 5200.16?

This is a legal form that was released by the U.S. Department of the Treasury - Alcohol and Tobacco Tax and Trade Bureau on April 1, 2010 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2010;
  • The latest available edition released by the U.S. Department of the Treasury - Alcohol and Tobacco Tax and Trade Bureau;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of TTB Form 5200.16 by clicking the link below or browse more documents and templates provided by the U.S. Department of the Treasury - Alcohol and Tobacco Tax and Trade Bureau.

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OMB No. 1513-0078 (02/28/2013)
FOR TTB USE ONLY
DEPARTMENT OF THE TREASURY
Number
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
APPLICATION FOR AMENDED PERMIT TO MANUFACTURE
TOBACCO PRODUCTS OR PROCESSED TOBACCO OR TO
Date
OPERATE AN EXPORT WAREHOUSE
1.
This application is submitted to request an amendment to my TTB permit number
to conduct business as a:
Manufacturer of Tobacco Products
Manufacturer of Processed Tobacco
Proprietor of an Export Warehouse
2.
Name and address shown on my permit:
3.
My employer identification number is (Read instruction F) :
4.
I have attached my permit to this TTB form for amendment (Read instruction G).
OR
I have NOT attached my permit to this application because:
5.
a.
I have changed my legal name (Read instruction H)
b.
I am removing or adding trade name(s) as follows: (Read instructions I and J)
Remove trade name(s) from my permit:
Add trade name(s) to my permit:
c.
I have attached the document(s) to show this change (such as amended articles of incorporation or trade name certificate).
OR
I have NOT attached the document(s) to show this change because:
I am reporting that the mailing address of my premises has changed (but not its physical location) to:
6.
My new Mailing address is:
7.
I intend to relocate my premises as a Manufacturer of Processed Tobacco. (Read instruction K)
My new Manufacturer of Processed Tobacco premises address is:
TTB F 5200.16 (04/2010) PREVIOUS VERSIONS SUPERSEDED AND MAY NOT BE USED
Page 1 of 2
OMB No. 1513-0078 (02/28/2013)
FOR TTB USE ONLY
DEPARTMENT OF THE TREASURY
Number
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
APPLICATION FOR AMENDED PERMIT TO MANUFACTURE
TOBACCO PRODUCTS OR PROCESSED TOBACCO OR TO
Date
OPERATE AN EXPORT WAREHOUSE
1.
This application is submitted to request an amendment to my TTB permit number
to conduct business as a:
Manufacturer of Tobacco Products
Manufacturer of Processed Tobacco
Proprietor of an Export Warehouse
2.
Name and address shown on my permit:
3.
My employer identification number is (Read instruction F) :
4.
I have attached my permit to this TTB form for amendment (Read instruction G).
OR
I have NOT attached my permit to this application because:
5.
a.
I have changed my legal name (Read instruction H)
b.
I am removing or adding trade name(s) as follows: (Read instructions I and J)
Remove trade name(s) from my permit:
Add trade name(s) to my permit:
c.
I have attached the document(s) to show this change (such as amended articles of incorporation or trade name certificate).
OR
I have NOT attached the document(s) to show this change because:
I am reporting that the mailing address of my premises has changed (but not its physical location) to:
6.
My new Mailing address is:
7.
I intend to relocate my premises as a Manufacturer of Processed Tobacco. (Read instruction K)
My new Manufacturer of Processed Tobacco premises address is:
TTB F 5200.16 (04/2010) PREVIOUS VERSIONS SUPERSEDED AND MAY NOT BE USED
Page 1 of 2
curtail the premises where I manufacture tobacco products. (Read instruction L)
8.
I intend to
relocate,
extend, or
curtail my export warehouse premises. (Read instruction L)
I intend to
relocate,
extend, or
My new premises address is:
I have attached a description and, if necessary, a diagram of my tobacco products factory or export warehouse.
I have NOT attached a description or diagram for the following reason:
9.
I declare that I have read the instructions for this form including the need to file other TTB forms. I understand that I may need to
file these TTB forms before TTB may act on this application. I understand that this application includes the information that I have
attached to this form or to which I have made a reference. I understand that an appropriate TTB officer may require additional
information to determine that I am entitled to the amended permit for which I am applying. Under penalties of perjury, I have
examined this application, and to the best of my knowledge and belief, this application, including any attachments, is true, correct,
and complete.
a.
Signature (See instruction M)
b.
Title
c.
Date
d.
My E-mail Address
e.
My Business Telephone Number
(
)
Send this form to the Director, TTB National Revenue Center, 550 Main Street, Suite 8002, Cincinnati, OH 45202.
TTB F 5200.16 (04/2010) PREVIOUS VERSIONS SUPERSEDED AND MAY NOT BE USED
Page 2 of 2
OMB No. 1513-0078 (02/28/2013)
DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
APPLICATION FOR AMENDED PERMIT TO MANUFACTURE TOBACCO PRODUCTS OR
PROCESSED TOBACCO OR TO OPERATE AN EXPORT WAREHOUSE
(INSTRUCTIONS)
1. GENERAL INSTRUCTIONS
A. Why do I need this form? Use this form to amend your permit to manufacture tobacco products or to manufacture
processed tobacco or to operate an export warehouse under Chapter 52 of Title 26 of the United States Code
(Internal Revenue Code). Applying for an amended permit does not authorize you to operate contrary to any Federal,
State, or local laws.
B. When do I have to file this form to amend my permit and do I have to wait for TTB to approve it?
When may I make the
1) You must file this form if
When do I file the
Which item on this form
change?
you:
application?
do I complete?
a) Relocate your permit
Before you relocate
Wait for TTB Approval
Item 7 or 8
operations
b) Change the address of
Within 30 days of the
TTB approval not required
Item 6
your Permit operations
change
before the change
(not the physical
location)
c) Extending or curtailing
Before extending or
Wait for TTB Approval
Item 8
your premises where
curtailing
you manufacture
tobacco products or
your export warehouse
d) Change your legal name Within 30 days
TTB approval not required
Items 5a and 5c
before the change
e) Add or remove trade
Within 30 days
TTB approval not required
Items 5b and 5c
names
before the change
2) You are NOT required to
file this form if you:
What do I file with TTB?
When may I make the change?
a) Have a change in
TTB F 5200.3 – change
Wait for TTB Approval
ownership of the
in ownership requires the
business covered by
new owner to apply for a
your TTB permit
new permit
b) Change in officers or
A letter notice reporting the
TTB approval not required before the change
directors of a
change
corporation
TTB F 5200.16 (04/2010) PREVIOUS VERSIONS SUPERSEDED AND MAY NOT BE USED
Instructions: Page 1 of 4
1) You are NOT required to
file this form if you:
What do I file with TTB?
When may I make the change?
c) Change in stock
ownership
If TTB F 5200.3 is filed within 30 days, operations may
i. Controlling interest
TTB F 5200.3 – change
in control requires the new
continue under current permit until new application is
ownership to apply for a
acted upon by TTB
new permit
ii. Person(s) holding
A letter notice reporting the
TTB approval not required before the change
more than10%
change
interest
d) Have a change in
A letter notice reporting the
TTB will advise whether further filings are required.
limited liability company
change
Changes that involve actual or legal control of the
membership:
business will require filing for a new permit using TTB
F 5200.3
C. How do I file this form? Send this form to the Director, TTB National Revenue Center, 550 Main Street, Ste. 8002,
Cincinnati, OH 45202. We recommend that you keep a copy of what you send.
D. Can I incorporate information that TTB already has on file? Yes, if you include, from the item(s) filed:
(1) The name, address and TTB permit number that appears on the TTB form referenced;
(2) The TTB form and item number; and
(3) The date that the TTB form was signed.
E. What if there is not enough space for my information? Attach a separate sheet with any additional information.
On this form in the space provided next to the item number, state that you have attached a separate sheet. Any
attachment to this form must include this TTB form number (TTB F 5200.16) and the item number(s) to which the
information corresponds.
INSTRUCTIONS FOR SPECIFIC ITEMS
F. Item 3. What is my employer identification number? This is the nine-digit code that the Internal Revenue Service
(IRS) assigns to your business. If you do not have an employer identification number, you may obtain one by filing an
IRS Form SS-4. You may get this form from the IRS. You may also obtain an EIN by applying online at
www.irs.gov.
G. Item 4. When do I have to attach my permit? You must always attach your permit. If you cannot locate your
permit, you must state this fact.
H. Item 5.
1) What is my legal name?
Your business is a:
Your legal name is:
Sole Proprietorship
Your full name.
The name of each partner or the name of the partnership as filed
Partnership
with a State or local government.
TTB F 5200.16 (04/2010) PREVIOUS VERSIONS SUPERSEDED AND MAY NOT BE USED
Instructions: Page 2 of 4
Your business is a:
Your legal name is:
Corporation, association, limited liability
The name as stated on your documents filed with the State or local
company, or other business organization
government.
2) What documents must I file?
If your business is a:
Attach to this application:
Accurate copy of certificate, issued by State, county, or municipality, which shows the
Sole Proprietorship
change in your name.
Accurate copy of articles OR the certificate required to be filed by any State, county,
Partnership or Association
or municipality.
Accurate copy of the corporate charter OR certificate of corporate existence or
incorporation, or other corporate document that shows your new legal name.
Corporation
This copy must be executed by the appropriate officer of the State in which your
business is incorporated.
Accurate copy of the business document(s) that shows your new legal name filed
Limited Liability Company
with a State, county, or municipality when such filing is required.
or other business
organization
The copy must show that it was filed with the appropriate government agency.
Item 5. What is a trade name? In general, a trade name is used to identify your business that is not its legal name.
I.
For example, your legal name may be ABC Corporation, but you use ABC Tobacco Products in your business
operations. Business operations include any name with which you identify your business on invoices or letterhead.
Also, business operations include a name that identifies your business on packages of tobacco products or cigarette
papers and tubes.
J. Item 5. Am I required to have a trade name certificate? Your State, county, or municipal authority may require a
trade name certificate to operate your business under a trade name. If your State, county, or municipal authority does
not require a trade name certificate, state this fact in item 5c.
K. Item 7. Relocation of manufacturer of processed tobacco: State the number, street, city, and State of the location
of your factory premises to be covered by your permit.
L. Item 8. Relocation, extension or curtailment of tobacco products factory or export warehouse:
1) What must I include in my description of my tobacco products factory or export warehouse? State the
number, street, city, and State of the location of your factory or export warehouse premises to be covered by your
permit.
2) When do I need a diagram?
(a) Your tobacco products factory or export warehouse is more than one building and each building cannot be
identified by a separate street address. Identify each building by a letter, number, or similar designation.
(b) Your tobacco products factory or export warehouse uses only a part of a building. Show the floor and room(s)
in the building.
(c) Your tobacco products factory adjoins a retail store. Show any doors or other openings between the factory
and the retail store.
TTB F 5200.16 (04/2010) PREVIOUS VERSIONS SUPERSEDED AND MAY NOT BE USED
Instructions: Page 3 of 4
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