Form Ttb F 5120.17 - Report Of Wine Premises Operations - 2014

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OMB No. 1513-0053
DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
REPORT OF WINE PREMISES OPERATIONS
OPERATED BY
PERIOD COVERED
(Name, Address, and Telephone)
(Year Only, or Year & Month, or Year & Quarter)
YEAR
MONTH
_______ _____
_______________
January to March
July to September
April to June
October to December
_______________ _______________ _______________
_______________ _______________ _______________ _______________ _______________ _______________ _______________ _______________
_______________
VERSION
EIN
REGISTRY NUMBER
(Select Original or Amended. Select Final also if last report for the business)
_______________
_______________ _______________ _______________
_______________
_______________
_______________ _______________ _______________
_________
Original
Amended
Final Report
INSTRUCTIONS
3. Explain any unusual operations in Part X.
1. The reporting period for this form must be monthly, except that proprietors who qualify under
the exception stated in 27 CFR 24.300(g)(2) may file this form on a
calendar year
4. The quantities "on hand end" will ordinarily be "book inventory" figures, that is the quantity
required to file monthly by the Alcohol and Tobacco Tax and Trade Bureau (TTB).
required to balance each summary. Use the "on hand end" from your report for the previous period
who files monthly reports but does not expect any reportable operations in a
as the "on hand beginning" of the current report. On reports for any period when you take a
or months may indicate in Part X that no monthly reports will be filed until a
physical inventory, report the difference as losses for bulk wine and shortages for bottled wine, or as
occurs (§ 24.300(g)(1)).
gains, as the case may be.
2. Prepare this form in duplicate and file it by the fifteenth day after the end of the report period
5. If the quantity of wine previously reported on TTB F 5120.17 is affected by adjustments made on
(
or year) . Keep the copy on your bonded wine premises for inspection by TTB
a tax return, TTB F 5000.24, adjust the current TTB F 5120.17 in Section A (and Section B, if
Send the original to TTB at this address:
bottled wine is involved) . Explain the entries in Part X.
Tobacco Tax and Trade Bureau, 550 Main St, Ste 8002, Cincinnati, OH 45202-5215.
_______________
_______________ _______________ _______________
_______________
_______________
_______________ _______________ _______________
_________
PART I - SUMMARY OF WINES IN BOND (GALLONS)
ALCOHOL CONTENT BY VOLUME
ARTIFICIALLY
CARBONATED
NOT OVER 14
OVER 14 TO 21 PERCENT
OVER 21 TO 24 PERCENT
SPARKLING WINE
HARD CIDER
ITEM
WINE
PERCENT
(Inclusive)
(Inclusive)
(e)
(f)
(d)
(a)
(b)
(c)
SECTION A - BULK WINES
1. ON HAND BEGINNING OF PERIOD
BF
2. PRODUCED BY FERMENTATION
1/
BP
3. PRODUCED BY SWEETENING
4. PRODUCED BY ADDITION OF WINE SPIRITS
5. PRODUCED BY BLENDING
6. PRODUCED BY AMELIORATION
7. RECEIVED IN BOND
8. BOTTLED WINE DUMPED TO BULK
9. INVENTORY GAINS
10.
11.
12.
TOTAL
BF
13. BOTTLED
2/
BP
14. REMOVED TAXPAID
15. TRANSFERS IN BOND
16. REMOVED FOR DISTILLING MATERIAL
17. REMOVED TO VINEGAR PLANT
18. USED FOR SWEETENING
19. USED FOR ADDITION OF WINE SPIRITS
20. USED FOR BLENDING
4/
21. USED FOR AMELIORATION
22. USED FOR EFFERVESCENT WINE
23. USED FOR TESTING
24.
25.
26.
27.
28.
29. LOSSES (OTHER THAN INVENTORY)
30. INVENTORY LOSSES
31. ON HAND END OF PERIOD
32.
TOTAL
SECTION B - BOTTLED WINES
1. ON HAND BEGINNING OF PERIOD
2. BOTTLED
BF
2/
BP
3. RECEIVED IN BOND
4. TAXPAID WINE RETURNED TO BOND
5.
6.
7.
TOTAL
8. REMOVED TAXPAID
9. TRANSFERRED IN BOND
10. DUMPED TO BULK
11. USED FOR TASTING
12. REMOVED FOR EXPORT
13. REMOVED FOR FAMILY USE
14. USED FOR TESTING
15.
16.
17.
18. BREAKAGE
19. INVENTORY SHORTAGE
3/
20. ON HAND END OF PERIOD
21.
TOTAL
TTB F 5120.17 (12/2014)
Enter in col. (e) on line marked "BF" the quantity of spar ling wine produced by fermentation in bottles, and on line marked "BP" the quantity of spar ling wine produced by bulk process.
1/
Section A line 13 and Section B line 2 should sho the same quantities. Enter in col. (e) on line marked "BF" the quantity of finished bottle fermented sparkling wine bottled, and on line mar ed "BP" the quantity of finished b lk process wine
2/
bottled.
Fully explain in either Part X, or on a sepa te signed statement submitted with this report. Failure to satisfactorily explain shortages of bottled wine ma result in the assessment of tax s applicable to those shortages.
3/
Only report blending if wines of diff rent tax classes are b ended together.
4/
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