TTB Form 5110.42 "Certificate of Authenticity Bourbon Whiskey"

What Is TTB Form 5110.42?

This is a legal form that was released by the U.S. Department of the Treasury - Alcohol and Tobacco Tax and Trade Bureau on July 1, 2006 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2006;
  • 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 5110.42 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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Download TTB Form 5110.42 "Certificate of Authenticity Bourbon Whiskey"

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Number
DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
Certificate of Authenticity Bourbon Whiskey
1. Consignor (full name and address)
2. Consignee (full name and address)
3. Means of transport
4. Issuing body
United States Department of the Treasury
United States Department of the Treasury
Name of Boat, Ship, or Vessel
Alcohol and Tobacco Tax and Trade Bureau
Alcohol and Tobacco Tax
Notes
Name of Airline
5. Serial numbers and marks - Number and kind of packages
6. Gross mass (kg)
7. Net mass (kg)
8. Number of casks
9. Number of bottles
10. Quantity in liters
11. Observations
The Alcohol and Tobacco Tax and Trade Bureau certifies that the above Bourbon whiskey was distilled in the United
̊ ̊ ̊
̊ ̊ ̊
States at not exceeding 160
proof (8O
Gay-Lussac) from a fermented mash of grain of which not less than 51% was
corn grain (maize), and aged for not less than two years in charred new oak containers.
Place and date
Signature of authorized Bureau Officer
Seal of the Department of the Treasury
12. Reserved for the customs authorities in the community
TTB F 5110.42 (7/2006)
Number
DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
Certificate of Authenticity Bourbon Whiskey
1. Consignor (full name and address)
2. Consignee (full name and address)
3. Means of transport
4. Issuing body
United States Department of the Treasury
United States Department of the Treasury
Name of Boat, Ship, or Vessel
Alcohol and Tobacco Tax and Trade Bureau
Alcohol and Tobacco Tax
Notes
Name of Airline
5. Serial numbers and marks - Number and kind of packages
6. Gross mass (kg)
7. Net mass (kg)
8. Number of casks
9. Number of bottles
10. Quantity in liters
11. Observations
The Alcohol and Tobacco Tax and Trade Bureau certifies that the above Bourbon whiskey was distilled in the United
̊ ̊ ̊
̊ ̊ ̊
States at not exceeding 160
proof (8O
Gay-Lussac) from a fermented mash of grain of which not less than 51% was
corn grain (maize), and aged for not less than two years in charred new oak containers.
Place and date
Signature of authorized Bureau Officer
Seal of the Department of the Treasury
12. Reserved for the customs authorities in the community
TTB F 5110.42 (7/2006)