Form Ttb F 5110.51 - Application, Permit, And Report-Distilled Spirits Products (Puerto Rico) Page 2

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PART IV — REPORT OF PREPAID TAXES

TO THE COMMONWEALTH INTERNAL REVENUE AGENT

TTB F 5000.25, with remittance in the full amount of the tax shown in Part III, has been received.

15. DATE

16. DISTRICT DIRECTOR (INVESTIGATIONS),

16a. BY (Signature and official title)

PUERTO RICO OPERATIONS

PART V — REPORT OF RELEASE

TO THE SECRETARY OF THE TREASURY OF PUERTO RICO

17.

TTB F 5000.25, with remittance in full, has been received by the District Director (Investigations), Puerto Rico Operations.

The applicant has on file a good and sufficient bond covering the taxes described in Part III; therefore, the liquors or articles made with distilled

spirits described in Part I have been released.

18. DATE

19. REVENUE AGENT

INSTRUCTIONS

GENERAL. The applicant must prepa re his/her form in quintuplicate.

(b) DEFERRED PAYMENT. If the t ax is to b e deferred, the applicant

Forms must be s erially numbered, beginning with "1" each calendar year,

must, after executing his/her agreement to pay in Part Ill, deliver all copies

and running con secutively therea fter to the e nd of the year. The serial

of this form and all copies of TTB F 5000.25 to the revenue agent.

number must be prefixed by the last two digits of the year, e.g., “10-1.”

5. PART IV. This part must be dated and signed b y the District Dir ector

2. PART I. After executing Part I, the applicant must forward all copies

(Investigations), Puerto Ri co Operations, TTB, if the ta x is prep aid.

of the form to the Secretary of the Treasury of Puerto Rico.

He/she must then forward one copy of TTB F 5000.25, to the Secretary,

and four copies of this fo rm and t he ga uge repo rt, if any, to the

3. PART II. After executing the permit in Part II, the Secretary must retain

revenue agent, and retain the original of each form for his/her files.

one copy for his/her files and forward the original and remaining copies to

the revenue ag ent at the prem ises where the liquors or articles are

6. PART V. This part must be executed by the revenue agent after deter-

stored. The reve nue agent must gauge the liquors or articles,

make a

mining that the applicant has pr oper bo nd cover age, or, in the case of

report of this gauge, and deliver all copies of this for m and TTB F 5000.25

prepayment, on receipt of this form from the District Director (Investigations),

to the applicant.

Puerto Ri co Op erations repo rting his /her receipt of TTB

F 5000.25

with remittance in full. The revenue agent must then forward one

4. PART III

copy of this form and the gauge report, if any, to the Insular Liquor Bureau,

(a) PREPA YMENT. If the tax is to be prepaid, the applicant m

ust so

and one copy of each to the District Revenue Agent (Commonwealth

indicate in Part Il l. On executing Part III, the a pplicant must pre pare TTB

of Puerto Rico), deliver on e copy of each to the applicant s, and retain

F 5000.25 in accordance with the instructions thereon, and send al l cop-

one cop y of each for his/her files.

ies of this form, all copies of TT B F 5 000.25, an d the f ull amoun t of the

tax, to the District Director (Investigations), Puerto Rico Operations, TTB.

PAPERWORK REDUCTION ACT NOTICE

This request is in accordance with the Paperwork Reduction Act of 1995. The information collection is used to determine the eligibility of the person

to compute the tax on, taxpay, and withdraw liquors or articles made with distilled spirits. The information is mandatory by statute (26 U.S.C. 7652).

The estimated average burden associated with this information collection is 1 hour per respondent or recordkeeper depending on the individual

circumstances. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be directed to the

Reports Management Officer, Regulations and Rulings Division, Alcohol and Tobacco Tax and Trade Bureau, Washington, DC 20220.

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 5110.51 (04/2010)