TTB Form 5120.25 "Application to Establish and Operate Wine Premises"

What Is TTB Form 5120.25?

This is a legal form that was released by the U.S. Department of the Treasury - Alcohol and Tobacco Tax and Trade Bureau on November 1, 2016 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2016;
  • 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 5120.25 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 5120.25 "Application to Establish and Operate Wine Premises"

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OMB No. 1513-0009
1. SERIAL NUMBER
DEPARTMENT OF THE TREASURY
2. DATE
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
APPLICATION TO ESTABLISH AND OPERATE WINE PREMISES
3. REGISTRY NUMBER
(Leave blank if
(See Instructions on next page)
new applicant)
4. TO: DIRECTOR, NATIONAL REVENUE CENTER
5. APPLICATION IS MADE TO OPERATE (Check one only)
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
BONDED
BONDED WINE
TAX PAID WINE
550 Main St., Suite 8002, Cincinnati, Ohio 45202-5215
WINERY
CELLAR
BOTTLING HOUSE
6. NAME AND PRINCIPAL BUSINESS ADDRESS OF APPLICANT
7. ADDRESS (Address where wine operations will occur.)
(Name and street, city, county, State, and ZIP Code)
(If different from address in Item 6)
PHONE #
EIN#
PHONE #
8. PURPOSE FOR WHICH FILED (Such as original establishment, trade name change, alteration of premises)
Original:
New Premises or change in Proprietorship
Alternating Proprietorship with:
Amended for:
Change in Location
Change in Control (Date_/_/_)
Alternating Premises with:
Change in information on
Other: Please Specify
application
Change in Officers
Change in Name of Proprietor or Trade Name
9.
I am
required to furnish a bond under 27 CFR 24.146. I am not required to furnish a bond only if all of the following are true: I will
or am not
withdraw wine for deferred payment of tax under 27 CFR 24.271, I was liable for not more than $50,000 in wine taxes in the preceding calendar year, I
reasonably expect to be liable for not more than $50,000 in such taxes during the current calendar year, and I have no operations or withdrawals
involving wine for industrial use.
10A. NUMBER OF PAGES ATTACHED TO THIS FORM ( ).
10A-1. PAGES FROM CURRENT APPR OVED TTB F 5120.25 THAT REMAIN
PAGE NUMBERS
PAGE NUMBERS
10B. ORGANIZATIONAL DOCUMENTS SUBMITTED WITH THIS FORM
10B-1. ORGANIZATIONAL DOCUMENTS FILED WITH PRIOR
(List each document)
APPROVED TTB F 5120.25 (List each document)
10C. ORGANIZATIONAL DOCUMENTS FILED IN CONNECTION WITH ANOTHER ESTABLISHMENT BUT INCORPORATED IN THIS APPLICATION BY
REFERENCE (List each document, and show the name or plant number under which filed)
NO WINE MAY BE PRODUCED OR UNTAXPAID WINE RECEIVED UNTIL THE PREMISES AND OPERATIONS ARE APPROVED BY THE DIRECTOR,
NATIONAL REVENUE CENTER.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE EXAMINED THIS APPLICATION AND, TO THE BEST OF MY KNOWLEDGE AND
BELIEF, IT IS TRUE, CORRECT, AND COMPLETE.
11. SIGNATURE
12. TITLE
FOR TTB USE ONLY
APPLICATION IS
EFFECTIVE DATE
APPROVED
DISAPPROVED
SIGNATURE OF DIRECTOR, NATIONAL REVENUE CENTER
DATE
TTB F 5120.25 (11/2016)
Page 1 of 2
OMB No. 1513-0009
1. SERIAL NUMBER
DEPARTMENT OF THE TREASURY
2. DATE
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
APPLICATION TO ESTABLISH AND OPERATE WINE PREMISES
3. REGISTRY NUMBER
(Leave blank if
(See Instructions on next page)
new applicant)
4. TO: DIRECTOR, NATIONAL REVENUE CENTER
5. APPLICATION IS MADE TO OPERATE (Check one only)
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
BONDED
BONDED WINE
TAX PAID WINE
550 Main St., Suite 8002, Cincinnati, Ohio 45202-5215
WINERY
CELLAR
BOTTLING HOUSE
6. NAME AND PRINCIPAL BUSINESS ADDRESS OF APPLICANT
7. ADDRESS (Address where wine operations will occur.)
(Name and street, city, county, State, and ZIP Code)
(If different from address in Item 6)
PHONE #
EIN#
PHONE #
8. PURPOSE FOR WHICH FILED (Such as original establishment, trade name change, alteration of premises)
Original:
New Premises or change in Proprietorship
Alternating Proprietorship with:
Amended for:
Change in Location
Change in Control (Date_/_/_)
Alternating Premises with:
Change in information on
Other: Please Specify
application
Change in Officers
Change in Name of Proprietor or Trade Name
9.
I am
required to furnish a bond under 27 CFR 24.146. I am not required to furnish a bond only if all of the following are true: I will
or am not
withdraw wine for deferred payment of tax under 27 CFR 24.271, I was liable for not more than $50,000 in wine taxes in the preceding calendar year, I
reasonably expect to be liable for not more than $50,000 in such taxes during the current calendar year, and I have no operations or withdrawals
involving wine for industrial use.
10A. NUMBER OF PAGES ATTACHED TO THIS FORM ( ).
10A-1. PAGES FROM CURRENT APPR OVED TTB F 5120.25 THAT REMAIN
PAGE NUMBERS
PAGE NUMBERS
10B. ORGANIZATIONAL DOCUMENTS SUBMITTED WITH THIS FORM
10B-1. ORGANIZATIONAL DOCUMENTS FILED WITH PRIOR
(List each document)
APPROVED TTB F 5120.25 (List each document)
10C. ORGANIZATIONAL DOCUMENTS FILED IN CONNECTION WITH ANOTHER ESTABLISHMENT BUT INCORPORATED IN THIS APPLICATION BY
REFERENCE (List each document, and show the name or plant number under which filed)
NO WINE MAY BE PRODUCED OR UNTAXPAID WINE RECEIVED UNTIL THE PREMISES AND OPERATIONS ARE APPROVED BY THE DIRECTOR,
NATIONAL REVENUE CENTER.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE EXAMINED THIS APPLICATION AND, TO THE BEST OF MY KNOWLEDGE AND
BELIEF, IT IS TRUE, CORRECT, AND COMPLETE.
11. SIGNATURE
12. TITLE
FOR TTB USE ONLY
APPLICATION IS
EFFECTIVE DATE
APPROVED
DISAPPROVED
SIGNATURE OF DIRECTOR, NATIONAL REVENUE CENTER
DATE
TTB F 5120.25 (11/2016)
Page 1 of 2
GENERAL INSTRUCTIONS
1. Each person desiring to conduct the operations of a bonded wine cellar, a
3.
DISCLOSURE. If this application is not for a bonded wine premises in which
bonded winery, or a taxpaid wine bottling house must file this application, in
production operations will be conducted and, thus a Federal Alcohol
duplicate, with the Director, National Revenue Center, Alcohol and Tobacco
Administration Act basic permit is not required, would you agree to the listing
Tax and Trade Bureau (TTB), at the address in Item 4.
of your name in a TTB publication which may be distributed to the general
public upon request? A “no” response will have no effect on the consideration
2. The application information required will be on letter-sized paper with each
of this application. Under 26 U.S.C. 6103, you have a legal right not to give
attached page identified with the name of the applicant, the serial number of
this release.
the application and the number of the page.
4.
TRADE NAME. List each trade name to be used in connection with the wine
3. The proprietor is responsible for keeping information of an approved
operations. If State or local law requires registration, certify that each trade
application current and complete. When required by 27 CFR Part 24, the
name is registered. State the operating name if other than the name in Item 6.
proprietor must submit an amended application with supplemental or
If a trade name is listed in any basic permit issued, such trade name is not
replacement pages or other documents necessary to update the previously
required to be included in this application.
approved application. Replacement pages must be numbered to correspond
to the pages being replaced.
5.
SPIRITS OPERATIONS. Describe any operation which will involve the use
of spirits.
4. If this application is for a taxpaid wine bottling house, you will not conduct
6.
BONDS AND PERMITS. With respect to this application, list all basic permits
spirits operations or need a bond, so paragraphs 6 and 7 of the specific
and bonds (including those filed with this application) showing the name and
instructions are not applicable.
the surety for each bond. Information related to bonds need not be provided if
no bond is required under 27 CFR 24.146.
5. Applications must be submitted in accordance with the instructions on
this form and in 27 CFR Part 24. Incomplete applications will be returned
7.
VOLATILE FRUIT-FLAVOR CONCENTRATE OPERATIONS. For volatile
to the applicant without action.
fruit-flavor concentrate producers, submit a step-by-step description of the
production process, commencing with obtaining the juice through each step
SPECIFIC INSTRUCTIONS
of the process to removal of the concentrate from the system. For production
of high-proof concentrate (more than 24 percent alcohol), indicate any step
Item 1. SERIAL NUMBER. Applications on this form must be serially numbered,
in the process at which the spirits are potable. Include the maximum quantity
commencing with serial number 1 for original establishment, and
in gallons of fruit must and volatile fruit-flavor concentrate produced in 24
continuing in sequence for each subsequent application. Applications for
hours; the maximum and minimum fold; and the maximum percent of alcohol
a taxpaid wine bottling house will be filed separately and likewise begin
in the concentrate for each kind of fruit used.
with serial number 1.
8.
OTHER OPERATIONS. Describe any other operations not specifically
Items 6 & 7. NAME AND ADDRESS. The address must be stated as explicitly as
authorized by Part 24 that are to be conducted on the wine premises. This
possible with a ZIP Code. If located in a city, the numbered street
must include a list of the premises and any major equipment used, and a
address and the name of the city will be given. If a rural address, give
statement as to the relationship, if any, of the operation to the wine operations.
the name of the county and nearest post office, with the approximate
These other operations need not be restricted to alcohol-related businesses.
distance and direction there from, including the name or number of
the road or highway on which situated.
PRIVACY ACT INFORMATION
ATTACHED STATEMENTS AND DOCUMENTS
The following information is provided pursuant to Section 3 of the Privacy Act of
1974 (5 U.S.C. 552a(e)(3)):
1.
BUSINESS ORGANIZATION. If a statement is already on file with TTB for
another authorization, only reference that authorization by name, address,
1.
AUTHORITY. Solicitation of this information is made pursuant to 26 U.S.C.
and registry number per 27 CFR 24.109(k). Attach a statement, if not already
5356. Disclosure of this information by the applicant is mandatory if the
on file, showing the type of business organization (e.g., sole owner,
applicant wishes to obtain authorization for operating a bonded wine cellar,
partnership, corporation, limited liability company) and the persons having
a bonded winery, or a taxpaid wine bottling house.
an interest in the business supported by the following:
2.
PURPOSE. To identify the applicant, to identify the nature, location, and
For corporations or limited liability companies:
the extent of the premises, the specific type or types of operations to be
conducted on the premises, and to determine the eligibility of the applicant
(a)
Charter or certificate of existence, incorporation, or organization,
to register the wine premises.
(b)
Names and addresses of officers, directors, members and managers.
(c)
Certified extracts of minutes authorizing certain individuals to sign.
3.
ROUTINE USES. The information will be used by TTB to make
(d)
Statement showing the number of shares/ownership of each class of stock/
determinations set forth in paragraph 2. In addition, the information may be
interest authorized and outstanding, and the voting rights of the respective
disclosed to other Federal, State, foreign, and local law enforcement and
owners or holders.
regulatory agency personnel to verify information on the form where such
Statement of interest: Names and addresses of the 10 persons having the
(e)
disclosure is not prohibited by law. The information may further be disclosed
largest ownership or other interest and nature and amount of the
to the Justice Department if it appears that the furnishing of false information
stockholding or other interest of each, whether the interest appears in the
may constitute a violation of Federal law. Finally, the information may be
name of the interested party or in the name of another party. The Director,
disclosed to members of the public in order to verify the information on the
National Revenue Center may request the names of interested persons if
form where such disclosure is not prohibited by law.
the applicant corporation or LLC is wholly owned or controlled by another
corporation or LLC.
4.
EFFECTS OF NOT SUPPLYING REQUESTED INFORMATION. Failure to
supply complete information will delay processing and may result in the
For partnerships:
denial of the application.
True copies of articles or partnership agreement, if any, and of the
PAPERWORK REDUCTION ACT NOTICE
certificate of partnership where required to be filed by local authority.
This request is in accordance with the Paperwork Reduction Act of 1995. This
2.
WINE PREMISES. Describe each tract of land comprising the wine
information collection is used by TTB to determine if the applicant is eligible to
premises. Description must be by directions and distances, in feet and inches,
receive a wine premises permit. The information is required to obtain a benefit.
with sufficient particularity to enable ready examination of the boundary of the
wine premises. Describe the means employed to afford security of the wine
The estimated average burden associated with this collection of information is 15
premises. Describe where and how any taxpaid wine will be stored on the
minutes per respondent or recordkeeper, depending on individual circumstances.
premises and the means used to segregate and identify taxpaid wine from
Comments concerning the accuracy of this burden estimate and suggestions for
untaxpaid wine. Describe any alternating areas. Each wine premises building
reducing this burden should be addressed to Reports Management Officer,
must be described as to size, construction, and use. Buildings not used for the
Regulations and Rulings Division, Alcohol and Tobacco Tax and Trade Bureau,
wine operations must be described only as to size and use. If wine premises
1310 G Street, NW., Box 12, Washington, DC 20005.
consists of a partial building, rooms or floors, each must be described
separately. Means of ingress and egress from the wine premises to adjoining
An agency may not conduct or sponsor, and a person is not required to respond
portions must be described.
to, a collection of information unless it displays a current, valid OMB control
number.
(a) If operating a bonded winery or bonded wine cellar in a residential building,
describe how the bonded premises are segregated from the residence and
what direct access to the bonded premises is available.
(b) If in an alternating proprietorship arrangement, provide a copy of the
alternation agreement showing that each proprietor will conduct
independent operations.
Page 2 of 2
TTB F 5120.25 (11/2016)
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