TTB F 5130 22 Brewer F513022
User Manual: Brewer
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DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
BREWER’S BOND
OMB No. 1513-0015 (03/31/2014)
Please check one box. This bond covers a:
Brewery
Pilot Brewing Plant
EIN:
(You must file two copies of this bond with original signatures.
Please see the instructions below.)
What is your brewery’s legal name?
If your brewery is a corporation, a limited liability company, a partnership, or
a limited partnership, list the State of Incorporation or organization.
What is your brewery’s mailing address?
(Number and Street)
What is the location of your brewery?
(City)
(County)
(State)
(ZIP Code)
(Number and Street)
(City)
What surety (or sureties) issues this bond?
(County)
(State)
(ZIP Code)
The amount of this bond is _________________________________ .
The bond type is (check one):
ORIGINAL
STRENGTHENING
The bond effective date is _______________________________________ .
SUPERSEDING
Penalties of Perjury Statement
I, the brewery, agree to all terms and conditions of the bond as listed below. I further declare under penalties of perjury that the persons owning,
controlling, or actively participating in the management of the brewery
have
have never compromised or been convicted in a court of competent
jurisdiction of:
• Any fraudulent noncompliance with any provision of law of the United States,
• if it relates to Internal Revenue or Customs taxation of distilled spirits, wines or beer, or
• if the offense is compromised with the individual, firm, partnership, corporation, or association on payment of penalties or otherwise;
OR
• Any felony under a law of any State or the District of Columbia, or the United States, prohibiting the manufacture, sale, importation, or
transportation of distilled spirits, wines, beer, or other intoxicating liquor. In the event that the above statements contain an affirmative answer,
you must submit a statement describing in detail the circumstances surrounding the conviction or compromise.
We, the brewery and surety, witness our hands and seals this __________ day of ______________ , _________________
Signed, sealed, and delivered in the presence of –
Brewery’s Legal Name ____________________________
Surety Company _________________________________
Signature ______________________________________
Signature _______________________________________
Name and Title __________________________________
Name and Title __________________________________
BREWERY
SEAL
Signature of Two Witnesses
(on behalf of brewery)
ONLY if brewery has no seal
SURETY
SEAL
___________________________________________________
___________________________________________________
___________________________________________________
Alcohol and Tobacco Tax and Trade Bureau –- Approval and Acceptance
On behalf of the United States of America, I approve and accept this brewer’s bond.
Director, National Revenue Center
Alcohol and Tobacco Tax and Trade Bureau
This bond expires on ___________________________________________
TTB F 5130.22 (07/2009)
Date Approved
What is the purpose of this bond?
We, the brewery (as principal) and the surety or sureties, promise ourselves to the United States of America for payment in the amount of this
bond in lawful money of the United States. This bond firmly binds ourselves, together and individually, our heirs, executors, administrators,
successors, and assigns.
At the premises identified in this bond the brewery is now engaged in, or intends to engage in:
These are the terms of this bond.
1.
What is the bond effective date?
The bond effective date is the date listed on the front of this bond. The bond will not in any case be effective before the date shown.
If no effective date is shown, the date the bond is signed will be the effective date.
2.
When does this bond expire?
expires
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These are the conditions of this bond.
1.
Liability: "" / 0 "
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(a) Liability as a brewery: I am liable for taxes for all beer removed for consumption or sale, including beer that I:
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1*2 remove without payment of tax for export, for use as supplies on vessels or aircraft, or for transfer to and
deposit in foreign-trade zones for exportation, which is not exported or used as authorized;
152 remove without payment of tax for laboratory analysis, or for authorized research, development or testing of processes, systems,
materials, or equipment relating to beer or brewery operations;
(5) remove without payment of tax to any distilled spirits plant for use as distilling material;
(6) remove without payment of tax for use of foreign embassies, legations, etc.; and
(7) remove without payment of tax for destruction.
(b) Liability as a pilot brewing plant: As a pilot brewing plant operator I am liable for taxes for all beer I brew, produce, or receive on
the pilot brewing plant.
2.
Faithful compliance: comply
3.
Full obligation:
4.
Changes while bond is in effect: We, the brewery and the surety (or sureties) agree that all stipulations, covenants, and agreements of this
bond extend and apply equally to any change in the business that requires a new or amended Brewer’s Notice for this brewery or pilot brewing
plant. This condition does not apply when the change is a change in the ownership of the business or is a change of location of the premises.
5.
We agree that TTB # " "
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6.
United States action if we breach any condition: On the breach of any of the conditions of this bond, the United States may pursue remedies
against the brewer or surety (or sureties) independently, or against both jointly. The surety (or sureties) waives any right or privilege to require
that the United States must first start an action, intervene in any action already started, or otherwise exhaust its remedies, against the brewer.
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TTB F 5130.22 (07/2009)
Privacy Act Information
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1.
What is TTB’s authority to ask for this information?!6
2.
What is the purpose for this information collection? I
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How does TTB routinely use this information? !
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What is the effect of my not supplying the information TTB requests?
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Brewer’s Bond — Instructions
1.
Where can I get assistance?
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2.
Why must I submit two copies with original signatures?
If we accept your bond, we will keep one copy in our files and return the duplicate copy to you for your records. Both copies must have original
signatures. The bond must be signed by someone who has authority to sign documents submitted to this Bureau on behalf of the brewery.
3.
Where do I send this bond?
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4.
What is an EIN?
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5.
What is a surety?
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6.
May I use more than one surety company?
Yes, you may use more than one surety company under the provisions of 27 CFR 25.98(d).
7.
How do I determine the bond amount?
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(a) Effective January 1, 2006, if your tax liability was not more than $50,000 in the previous calendar year, and you reasonably expect to be liable for not
amount is $1,000 1^&++ 2 # ^&++"+++7 -H%J7-&
more
current calendar year, you
may choose
than
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in
the
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to pay your taxes on a quarterly basis. For those breweries electing to pay their taxes
quarterly, the amount of the bond must be equal to 29 percent of the maximum amount of tax, calculated at the rates prescribed by law, which the brewer
will become liable to pay during the calendar year, or
(b) For those brewers who pay their taxes on a semimonthly basis, the amount of the bond must be equal to 10 percent of the maximum amount of tax,
calculated at the rates prescribed by law, which the brewer will become liable to pay during a calendar year, on beer:
(1) removed for transfer to the brewery from other breweries owned by the same brewer;
(2) removed without payment of tax for export or for use as supplies on vessels and aircraft;
(3) removed without payment of tax for use in research, development, or testing; and
(4) removed for consumption or sale.
The minimum bond amount is $1,000 ($500 for a pilot brewing plant). The maximum amount is $500,000. Please see 27 CFR Part 25 to determine the
appropriate bond amount, or call us toll-free at 1-877-882-3277 for assistance.
8.
What type of bond do I file?
! original
I strengthening #
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I a Brewer’s Bond Continuation Certificate, J &'*+-*"
TTB F 5130.22 (07/2009)
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9.
What do I list for “brewery’s name” and who signs this bond for me?
If the brewery is...
8 I Owner as a Sole
Proprietorship
Brewery Name and Signature
Then your brewery’s name on the bond
must include...
T the
And...
The OR L L
.
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partner
X OR Y
OR L L
.
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• Your
Limited Partnership's name
The person who is authorized to sign for the limited
partnership must give his or her signature and title
AND the limited partnership’s seal must be affixed.
If there is no seal, two witnesses must sign the bond.
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Or Y
10.
Y or
LLC must his or her ANDthe
corporate seal must be affixed. If there is no seal, two
witnesses must sign the bond.
Who may sign for a partnership, corporation, or LLC?
The person signing on behalf of the brewery must have current signing authority or a Power of Attorney on file with this office.
11. Who signs for the surety company?
Authorized persons sign for the surety, attested under the surety's seal. A Power of Attorney for the person signing on behalf of the surety
must be attached to both copies of the bond.
12. Do I need witness signatures if I have a corporate seal?
If your brewery has obtained a seal, it must be impressed on both copies of the bond. If your brewery has no seal, the signature for the brewery must
be made in the presence of two persons who will sign their names as witnesses.
13. Do I need to give an explanation if I have an affirmative answer in the Penalties of Perjury Statement?
Yes, under the provisions of 27 CFR 25.91(c), in the event the statement contains an affirmative answer, you must submit a statement describing in
detail the circumstances surrounding the conviction or compromise.
14. How do I make corrections to the bond if I make a mistake?
Where you make any alteration or erasure in the bond, you must incorporate a statement consenting to the alteration.
You must add this statement in the side margin of the bond. Both the person signing for the brewery and surety must initial the statement:
We consent to this correction to the bond: brewery
(initials)
and surety
(initials)
.
15. What if I download this form from the Internet and I cannot print both sides on one page?
We prefer that the bond be on a single sheet. However, if you cannot print both sides on one sheet, you may print two pages.
TTB F 5130.22 (07/2009)
Source Exif Data:
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