Formula and Process for Domestic and Imported Alcohol Beverages- TTB F 5100.51 (11/2009) OMB No. 1513-0122 (06/30/2012) |
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FORM FIELD NAME |
SCREEN NAME/TAB NAME |
SECTION HEADER |
SCREEN FIELD LABEL |
COMMENTS |
FORMULA # |
MAIN TAB |
N/A |
COMPANY FORMULA # |
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SUPERCEDING FORMULA (CHECK BOX) |
SUPERCEDED FORMULA/MAIN |
N/A |
ACTION: CREATE NEW FORMULA OR SUPERCEDE EXISTING FORMULA (RADIO BUTTON SELECTION) |
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1. NAME AND ADDRESS OF APPLICANT/IMPORTER |
COMPANY/COMPANY |
PERMIT HOLDER ADDRESS |
NAME |
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STREET |
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CITY |
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STATE |
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ZIP |
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1a. MAILING ADDRESS/FOREIGN PRODUCER'S ADDRESS |
ADDRESS/COMPANY |
COMPANY/ADDRESS DETAIL |
ADDRESS TYPE: DROP DOWN MENU--SELECT MAILING OR FOREIGN MANUFACTURE |
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ADDRESS FORMAT: DROP DOWN MENU--SELECT USPS DOMESTIC OR FOREIGN |
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FIRST NAME |
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LAST NAME |
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STREET |
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CITY |
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STATE |
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COUNTRY |
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REGION |
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PROVINCE |
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ZIP |
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FOREIGN POSTAL CODE |
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2. CONTACT PERSON'S PHONE NUMBER/EMAIL ADDRESS |
ADDRESS/COMPANY |
COMPANY/ADDRESS DETAIL |
ADDRESS TYPE: DROP DOWN MENU--SELECT CONTACT |
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ADDRESS FORMAT: DROP DOWN MENU--SELECT USPS DOMESTIC OR FOREIGN |
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FIRST NAME |
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LAST NAME |
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TELEPHONE |
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E-MAIL ADDRESS |
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STREET |
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CITY |
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STATE |
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COUNTRY |
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REGION |
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PROVINCE |
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ZIP |
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FOREIGN POSTAL CODE |
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3. PLANT REGISTRY/BASIC PERMIT/BREWER'S NUMBER |
COMPANY/COMPANY |
COMPANY/ADDRESS DETAIL |
PERMIT NUMBER |
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4. CLASS AND TYPE OF PRODUCT |
MAIN TAB |
N/A |
CLASS/TYPE DROP DOWN MENU |
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5. PRODUCT NAME |
MAIN TAB |
N/A |
PRODUCT NAME |
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6. QUANTITATIVE LIST OF INGREDIENTS |
FORMULA TAB |
INGREDIENTS |
FERMENTABLE INGREDIENTS |
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FINISHED ALCOHOL |
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FLAVORS |
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OTHER INGREDIENTS |
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7. METHOD OF MANUFACTURE/PROCESS OF PRODUCTION |
FORMULA TAB |
METHOD OF MANUFACTURE/PROCESS OF PRODUCTION |
METHOD OF MANUFACTURE/PROCESS OF PRODUCTION--TEXT BOX; CHECK BOX APPEARS THAT WILL ALSO ALLOW METHOD OF MANUFACTURE/PROCESS OF PRODUCTION TO BE UPLOADED TO 'DOCS/LINKS' TAB UNDER SUBMISSION DOCUMENTS |
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8. TOTAL YIELD |
FORMULA TAB |
SUMMARY |
MEASUREMENT TYPE: DROP DOWN MENU |
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MEASUREMENT UNITS: DROP DOWN MENU |
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TOTAL YIELD |
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9. ALCOHOL CONTENT OF FINISHED PRODUCT |
FORMULA TAB |
SUMMARY |
ALCOHOL CONTENT OF FINISHED PRODUCT: LOW AND HIGH RANGE/ UNITS |
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9a. AMOUNT OF ALCOHOL FROM FLAVORS |
FORMULA TAB |
SUMMARY |
ALCOHOL FROM FLAVORS: LOW AND HIGH RANGE/ UNITS |
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9b. AMOUNT OF ALCOHOL FROM BASE |
FORMULA TAB |
SUMMARY |
ALCOHOL FROM BASE: LOW AND HIGH RANGE/ UNITS |
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10. PRINTED NAME OF APPLICANT/IMPORTER |
MAIN TAB |
N/A |
N/A |
PRINTED NAME APPEARS ONCE APPLICANT LOGS INTO THE APPLICATION WITH USER ID AND PASSWORD AND SUBMITS. |
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11. BY (SIGNATURE AND TITLE) |
N/A |
N/A |
N/A |
ELECTRONIC SIGNATURE AS A RESULT OF APPLICANTS ELECTRONIC AGREEMENT TO PERJURY STATEMENT BEFORE SUBMITTING APPLICATION. |
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12. DATE |
N/A |
N/A |
N/A |
SYSTEM GENERATED BASED UPON WHEN APPLICATION IS SUBMITTED |
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FOR TTB USE ONLY (ITEMS 13,14, 15, AND 16) |
13. FORMULATION: WINE PRODUCTS/DISTILLED SPIRITS |
RESULTS TAB |
APPROVAL PROVISIONS |
APPROVAL PROVISIONS : ADD BUTTON ALLOWS SPECIALIST TO ADD PROVISIONS SPECIFICALLY FOR WINE PRODUCTS, DISTILLED SPIRITS PRODUCTS--DROP DOWN MENU |
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13. LABELING (FINISHED PRODUCT ONLY) |
RESULTS TAB |
LABELING INSTRUCTIONS |
LABELING INSTRUCTIONS--TEXT BOX ALLOWS SPECIALIS TO ADD INFORMATION REGARDING SUGGESTED STATEMENT OF COMPOSITION, COMMODITY STATEMENT, USE OF COLORS AND/OR ALLERGENS |
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14. DATE: |
RESULTS TAB |
DETERMINATION |
APPROVAL DATE--POPULATES TO CURRENT DATE OR SPECIALIST MAY ENTER IN APPROVAL DATE |
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15. APPROVED--TTB SPECIALIST FOR THE ADMINSTRATOR, ALCOHOL AND TOBACCO TAX AND TRADE BUREAU |
RESULTS TAB |
DETERMINATION |
DISPOSITION: DROP DOWN MENU ALLOWS SPECIALIST TO SELECT 'APPROVED' . |
ONCE SPECIALIST SELECTS A DETERMINATION, SUCH AS APPROVED OR REJECTED, THE APPLICATIONS IS GIVEN THE SPECIALISTS' ELECTRONIC SIGNATURE |
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16. EXPIRES (IMPORT ONLY) |
RESULTS TAB |
DETERMINATION |
EXPIRATION DATE: PRE-POPULATED WITH A DATE 5 YEARS FROM THE DATE OF APPROVAL |
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