Bwl-008 Label/product Approval Form

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North Carolina
Approved. . . . . . . . . . . . . . . . . .
Amount Fee Paid: _______________
Alcoholic Beverage Control Commission
Disapproved. . . . . . . . . . . . . . . .
Date: _________________________
4307 Mail Service Center
Date: ______________________
Received by: __________________
Raleigh, NC 27699-4307
(919) 779-0700
Check #: ______________________
N.C. Product Code #:
Label/Product Application
Above for office use only.
Company Name: __________________________________________________N.C. Permit # ____________________
Mailing Address: __________________________________________________________________________________
Contact Person: __________________________________________Email Address: ____________________________
Phone #: __________________________________________ Fax #: _________________________________________
New Product
Label Revision – Product Code # _______________
Transfer of Brand
Brand Name: ________________________________________Fanciful Name: _________________________________
Varietal/Type: ______________________________________________ Sizes: __________________________________
Primary Source? ___ No
___Yes (Attach letter)
Is Bordeaux? Yes____ No _____
NOTE: if received through a French Negociant, must submit Negociant Form.
PRODUCT ANALYSIS CERTIFICATION
I, ______________________________________________________, hereby verify that the above product is analyzed to
be ____________ % alcohol by volume.
Signature: ____________________________________________Title: _______________________________________
All labels that will appear on the container must be affixed below. Use back if necessary.
This form must be stapled to the Federal Certificate of Label Approval (COLA).
BWL-008
Rev. 4/14/2014

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