TTB Form 5110.58 "Certificate of Origin and Age of Distilled Spirits"

What Is TTB Form 5110.58?

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 5110.58 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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DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
Certificate of Origin And Age of Distilled Spirits
This is to certify that the distilled spirits described in this certificate were produced at the distillery identified
below, located in the United States of America, in compliance with the laws of the United States of America
and regulations issued under those laws and they were consigned for export to the location shown below.
PRODUCER
DISTILLERY REGISTRATION NO.
PREMISES ADDRESS
DATE CONSIGNED
LOCATION WHERE SPIRITS ARE TO BE EXPORTED
FOR EXPORT
DESCRIPTION OF SPIRITS
TYPE OF
CONTAINER
KIND OF
TYPE OF
MONTHS STORED ON
DATE
CONTAINER
IDENTIFICATION NUMBER
SPIRITS
COOPERAGE
PRODUCED
BONDED PREMISES
(a)
(b)
(c)
(d)
(e)
(f)
DATE OF ISSUANCE
Signature of authorized official of the Alcohol and Tobacco Tax and Trade Bureau
Alcohol and Tobacco Tax and Trade Bureau
TTB F 5110.58 (7/2006)
DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
Certificate of Origin And Age of Distilled Spirits
This is to certify that the distilled spirits described in this certificate were produced at the distillery identified
below, located in the United States of America, in compliance with the laws of the United States of America
and regulations issued under those laws and they were consigned for export to the location shown below.
PRODUCER
DISTILLERY REGISTRATION NO.
PREMISES ADDRESS
DATE CONSIGNED
LOCATION WHERE SPIRITS ARE TO BE EXPORTED
FOR EXPORT
DESCRIPTION OF SPIRITS
TYPE OF
CONTAINER
KIND OF
TYPE OF
MONTHS STORED ON
DATE
CONTAINER
IDENTIFICATION NUMBER
SPIRITS
COOPERAGE
PRODUCED
BONDED PREMISES
(a)
(b)
(c)
(d)
(e)
(f)
DATE OF ISSUANCE
Signature of authorized official of the Alcohol and Tobacco Tax and Trade Bureau
Alcohol and Tobacco Tax and Trade Bureau
TTB F 5110.58 (7/2006)