TTB Form 5130.6 "Drawback on Beer Exported"

What Is TTB Form 5130.6?

This is a legal form that was released by the U.S. Department of the Treasury - Alcohol and Tobacco Tax and Trade Bureau on January 1, 2019 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2019;
  • 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 5130.6 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. 1513-0017 (11/30/2020)
DEPARTMENT OF THE TREASURY
1. SERIAL NUMBER (The exporter
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
will number each form beginning
DRAWBACK ON BEER EXPORTED
with "1" each January 1.)
( Prepare in quadruplicate. See instructions on Page 2.) )
PART I - NOTICE
FOR TTB
NOTICE IS HEREBY GIVEN OF THE SHIPMENT OF TAXPAID BEER ON WHICH DRAWBACK OF INTERNAL
USE ONLY
REVENUE TAX PAID THEREON WILL BE CLAIMED BY THE BREWER WHO PAID THE TAX.
CLAIM NUMBER
2. NAME AND ADDRESS OF EXPORTER (Number, street, city, State, and ZIP Code)
DATE RECEIVED
3. NAME AND ADDRESS OF BREWER WHO PAID THE TAX
3a. EMPLOYER IDENTIFICATION
NUMBER
1
TTB F 5620.4 FILED WITH CLAIM
2
NO.
4. ADDRESS OF THE DIRECTOR, NATIONAL REVENUE CENTER,
550 MAIN ST, STE 8002, CINCINNATI, OHIO 45202-5215
AMOUNT CLAIMED
$
(Location)
(Number)
5. PURPOSE
SHIPMENT FOR EXPORT
TRANSFER TO
AMOUNT REJECTED
OF
TO ARMED FORCES
FOREIGN-TRADE
$
SHIP-
OF THE U.S.
ZONE
MENT
EXPORTATION TO (Name of foreign port and country)
AMOUNT APPROVED
(Make
$
applicable
USE AS SUPPLIES ON
CLAIMS CLERK
entries)
A VESSEL
3
AIRCRAFT
3
6. CON-
DIRECTOR OF CUSTOMS AT PORT OF
7. NAME OF DOMESTIC CARRIER
SIGNED
TO OR IN
TRANSPORTATION
(Name)
(Location)
CARE OF
OFFICER
8. NAME OF EXPORT CARRIER
(Make
applicable
CUSTOMS OFFICER IN
(Location)
(Number)
CHARGE OF FOREIGN-TRADE
entries)
ZONE
9. THE BEER WAS SHIPPED IN THE FOLLOWING CONTAINERS (Show container size as "1/4 bbl", "24/12", etc.)
NUMBER
KIND
NUMBER
KIND
SIZE
KIND
SIZE
NUMBER
SIZE
(d)
(h)
(a)
(b)
(c)
(e)
(f)
(g)
(i)
10. DATE
11. EXPORTER
11a. BY (Signature and title)
PART II - CLAIM
TO: DIRECTOR, NATIONAL REVENUE CENTER, ALCOHOL AND TOBACCO TAX AND TRADE BUREAU
The beer described in Part I has been removed for the purpose stated and is not to be brought back or relanded within the limits of the United States. The
quantity of beer, as described in Part I and restated below in terms of barrels, is correct, and such beer was brewed or produced in the United States. I am
justly entitled to drawback of tax in the amount claimed herein. Internal Revenue tax equal to such amount has been determined and paid as provided by law
and regulations. No other claim for allowance of drawback has been made on this beer or any part thereof.
13. QUANTITY OF BEER (Barrels)
14a. RATE OF TAX
4
12. DATE
14b. DRAWBACK CLAIMED
$
$
Under penalties of perjury, I declare that I have examined Part I hereof, and this claim, and to the best of my knowledge and belief the statements herein and
in Part I are true, correct, and complete.
1
15. BREWER
15a. BY (Signature and title)
The brewer who paid the tax must always complete item 3a.
1
2
Complete only for consolidated claims; show serial number of last claim tabulated.
3
State whether (a) Vessel or aircraft operated by the United States; (b) Vessel or aircraft engaged in foreign trade, or in trade between the United States and
any of its possessions, or between Hawaii or Alaska and any other part of the United States; (c) Vessel of the United States engaged in trade between
Atlantic and Pacific ports of the United States; (d) Vessel of war of any foreign nation; or (e) Vessel employed in (1) the fisheries, or (2) The whaling
business. Show name of vessel, country of registry, and ports of call, or, if a whaling vessel, location or operations. If aircraft, show also name of airline
and country of registry of aircraft.
Indicate the rate of tax paid on the beer exported. If the beer was produced by a brewer qualified under 27 CFR 25.152 that is eligible to pay at a reduced
4
rate of tax, drawback must be claimed at the reduced rate unless the brewer or the brewer’s agent can establish that the beer was taxpaid at the higher rate
of tax.
TTB F 5130.6 (01/2019)
Page 1 of 2
OMB No. 1513-0017 (11/30/2020)
DEPARTMENT OF THE TREASURY
1. SERIAL NUMBER (The exporter
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
will number each form beginning
DRAWBACK ON BEER EXPORTED
with "1" each January 1.)
( Prepare in quadruplicate. See instructions on Page 2.) )
PART I - NOTICE
FOR TTB
NOTICE IS HEREBY GIVEN OF THE SHIPMENT OF TAXPAID BEER ON WHICH DRAWBACK OF INTERNAL
USE ONLY
REVENUE TAX PAID THEREON WILL BE CLAIMED BY THE BREWER WHO PAID THE TAX.
CLAIM NUMBER
2. NAME AND ADDRESS OF EXPORTER (Number, street, city, State, and ZIP Code)
DATE RECEIVED
3. NAME AND ADDRESS OF BREWER WHO PAID THE TAX
3a. EMPLOYER IDENTIFICATION
NUMBER
1
TTB F 5620.4 FILED WITH CLAIM
2
NO.
4. ADDRESS OF THE DIRECTOR, NATIONAL REVENUE CENTER,
550 MAIN ST, STE 8002, CINCINNATI, OHIO 45202-5215
AMOUNT CLAIMED
$
(Location)
(Number)
5. PURPOSE
SHIPMENT FOR EXPORT
TRANSFER TO
AMOUNT REJECTED
OF
TO ARMED FORCES
FOREIGN-TRADE
$
SHIP-
OF THE U.S.
ZONE
MENT
EXPORTATION TO (Name of foreign port and country)
AMOUNT APPROVED
(Make
$
applicable
USE AS SUPPLIES ON
CLAIMS CLERK
entries)
A VESSEL
3
AIRCRAFT
3
6. CON-
DIRECTOR OF CUSTOMS AT PORT OF
7. NAME OF DOMESTIC CARRIER
SIGNED
TO OR IN
TRANSPORTATION
(Name)
(Location)
CARE OF
OFFICER
8. NAME OF EXPORT CARRIER
(Make
applicable
CUSTOMS OFFICER IN
(Location)
(Number)
CHARGE OF FOREIGN-TRADE
entries)
ZONE
9. THE BEER WAS SHIPPED IN THE FOLLOWING CONTAINERS (Show container size as "1/4 bbl", "24/12", etc.)
NUMBER
KIND
NUMBER
KIND
SIZE
KIND
SIZE
NUMBER
SIZE
(d)
(h)
(a)
(b)
(c)
(e)
(f)
(g)
(i)
10. DATE
11. EXPORTER
11a. BY (Signature and title)
PART II - CLAIM
TO: DIRECTOR, NATIONAL REVENUE CENTER, ALCOHOL AND TOBACCO TAX AND TRADE BUREAU
The beer described in Part I has been removed for the purpose stated and is not to be brought back or relanded within the limits of the United States. The
quantity of beer, as described in Part I and restated below in terms of barrels, is correct, and such beer was brewed or produced in the United States. I am
justly entitled to drawback of tax in the amount claimed herein. Internal Revenue tax equal to such amount has been determined and paid as provided by law
and regulations. No other claim for allowance of drawback has been made on this beer or any part thereof.
13. QUANTITY OF BEER (Barrels)
14a. RATE OF TAX
4
12. DATE
14b. DRAWBACK CLAIMED
$
$
Under penalties of perjury, I declare that I have examined Part I hereof, and this claim, and to the best of my knowledge and belief the statements herein and
in Part I are true, correct, and complete.
1
15. BREWER
15a. BY (Signature and title)
The brewer who paid the tax must always complete item 3a.
1
2
Complete only for consolidated claims; show serial number of last claim tabulated.
3
State whether (a) Vessel or aircraft operated by the United States; (b) Vessel or aircraft engaged in foreign trade, or in trade between the United States and
any of its possessions, or between Hawaii or Alaska and any other part of the United States; (c) Vessel of the United States engaged in trade between
Atlantic and Pacific ports of the United States; (d) Vessel of war of any foreign nation; or (e) Vessel employed in (1) the fisheries, or (2) The whaling
business. Show name of vessel, country of registry, and ports of call, or, if a whaling vessel, location or operations. If aircraft, show also name of airline
and country of registry of aircraft.
Indicate the rate of tax paid on the beer exported. If the beer was produced by a brewer qualified under 27 CFR 25.152 that is eligible to pay at a reduced
4
rate of tax, drawback must be claimed at the reduced rate unless the brewer or the brewer’s agent can establish that the beer was taxpaid at the higher rate
of tax.
TTB F 5130.6 (01/2019)
Page 1 of 2
PART III - CUSTOMS OFFICER'S CERTIFICATION OF LADING OR DEPOSIT
I HEREBY CERTIFY THAT THE BEER DESCRIBED IN PART I WAS FOUND TO BE AS DESCRIBED, EXCEPT AS NOTED IN ITEM 19, AND THAT THE BEER WAS --
16. LADEN FOR
AIRCRAFT (Name, symbols, number)
VESSEL (Name)
USE AS
EXPORT
TRUCK (State license)
SUPPLIES
RAILROAD CAR (Number)
ON BOARD
17. RECEIVED IN
SERIAL NUMBER OF SEALS USED
(Number)
18. SHIPPED TO (Frontier port)
FOREIGN-TRADE ZONE
19. INSPECTION DISCLOSED
DISCREPANCIES OR SHORT
NO DISCREPANCY
NO EVIDENCE OF TAMPERING
SHIPMENT AS FOLLOWS:
20. DATE
21. PORT
22. SIGNATURE AND TITLE OF CUSTOMS OFFICER
PART IV - CUSTOMS OFFICER'S REPORT OF THROUGH SHIPMENT AT FRONTIER PORT
25. INSPECTION DISCLOSED
23. FRONTIER PORT
24. DATE REC'D
NO EVIDENCE
SEALS BROKEN
SEALS INTACT
(See item 26)
OF TAMPERING
26. NATURE AND EXTENT OF DISCREPANCIES, TRANSSHIPMENT, RESEALING, ETC.
FOREIGN PORT
27. THE EXPORTING CONVEYANCE IDENTIFIED IN ITEM 16, BEARING THE BEER
DESCRIBED IN ITEM 9, WITH EXCEPTIONS AS NOTED IN ITEMS 19 AND 26,
CLEARED FROM THIS PORT FOR THE PORT OF
28. DATE
29. SIGNATURE AND TITLE OF CUSTOMS OFFICER
PART V - CERTIFICATE OF CLEARANCE OR USE
30. THE EXPORTING CONVEYANCE BEARING THE BEER DESCRIBED IN ITEM 9, WITH EXCEPTIONS AS NOTED ABOVE --
CLEARED FROM THE PORT OF
ON (Date)
BOUND FOR (Foreign port)
33. SIGNATURE OF DIRECTOR OF CUSTOMS
32. DATE
31. THE BEER HAS BEEN USED AS SUPPLIES ON THE
FISHING VESSEL IDENTIFIED ABOVE, AND THE
EVIDENCE OF SUCH USE HAS BEEN RECEIVED
PART VI - CERTIFICATE OF RECEIPT BY ARMED FORCES OFFICER
The beer described in Part I, with exceptions as noted in item 35, was received for export to the Armed Forces of the United States. The beer will not be
shipped for consumption or use in any place subject to application of the Internal Revenue laws of the United States.
34. DATE
35. DISCREPANCY
36. SIGNATURE
37. RANK
38. TITLE
INSTRUCTIONS
1. GENERAL. Prepare a separate TTB F 5130.6, in quadruplicate, for the products
must execute Part V, forward the original to the Director, National Revenue Center,
of each brewer. Under 27 CFR 28.226 an agent is a person who has on file with
Alcohol and Tobacco Tax and Trade Bureau at the address shown in item 4, and retain
the Director, National Revenue Center, Alcohol and Tobacco Tax and Trade Bureau, a
the copy for his\her files.
TTB F 5000.8, Power of Attorney, authorizing him/her to act on behalf of the principal.
(d) Lading at Interior Port For Exportation Through Frontier Port. On
2. SHIPMENT BY BREWER OR BREWER'S AGENT. Complete Parts I and II,
completion of lading, the Customs Officer must affix the customs seals, then execute
forward the original and one copy to the official designated in item 6, forward one
Part III on both copies and forward them to the Director of Customs at the interior port of
copy to the Director, National Revenue Center, Alcohol and Tobacco Tax and Trade
lading for forwarding to the Customs Officer at the frontier port. (Exception, if the
Bureau at the address shown in item 4, and retain the remaining copy for filing.
shipment is by truck and if instructions from the Director of Customs so provide, the
copies may be forwarded via the truck driver to the Customs Officer at the frontier
3. ACTION BY CUSTOMS.
port.) That officer, when satisfied that the shipment has been exported, must execute
(a) Shipment for Direct Exportation. After inspection of lading, the Customs
Part IV on both copies and return them to the Director of Customs at the interior port.
Officer must execute Part III on both copies and forward them to the Director of
The Director of Customs must then execute Part V, forward the original to the
Customs. On clearance at the conveyance, the Director of Customs must execute
Director, National Revenue Center, Alcohol and Tobacco Tax and Trade Bureau at the
Part V, forward the original to the Director, National Revenue Center, Alcohol and
address shown in item 4, and retain the copy for his/her files.
Tobacco Tax and Trade Bureau at the address shown in item 4, and retain the
copy for his/her files.
(e) Receipt in Foreign-Trade Zone. On receipt of the beer, the Customs
Officer must complete Part III on both copies, forward the original to the Director,
(b) Supplies on Aircraft and Vessels Other Than Fishing Vessels.
National Revenue Center, Alcohol and Tobacco Tax and Trade Bureau at the address
After inspection of lading, the Customs Officer must execute Part III on both copies,
shown in item 4, and retain the copy for his/ her files.
forward the original to the Director, National Revenue Center, Alcohol and Tobacco Tax
and Trade Bureau at the address shown in item 4, and retain the copy for his/her files.
4. ACTION BY ARMED FORCES OFFICER. On receipt of the beer, the officer to
whom consigned (or other authorized supply officer) must execute Part VI on both
(c) Supplies on Fishing Vessels. After inspection of lading, the Customs
copies, forward the original to the Director, National Revenue Center, Alcohol and
Officer must execute Part III on both copies and forward them to the Director of
Tobacco Tax and Trade Bureau at the address shown in item 4,and retain the copy for
Customs. The Director of Customs (on receipt of the required Customers Form 5125)
his/ her records.
PAPERWORK REDUCTION ACT NOTICE
This request is in accordance with the Paperwork Reduction Act of 1995. The information collection is used to obtain drawback of Federal taxes on beer exported from the United States.
This information is required to obtain a benefit by 26 U.S.C. 5055.
The estimated average burden associated with this collection of information is 1 hour per respondent or recordkeeper, depending on individual circumstances. Comments concerning the
accuracy of this burden estimate and suggestions for reducing this burden, should be addressed 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 a person is not required to respond to, a collection of information unless it displays a current, valid OMB control number.
TTB F 5130.6 (01/2019)
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