Form TTB F 5220.4 TTB F 5220.4 Report — Proprietor of Export Warehouse

OMB NO. 1513-0024
DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)

REPORT - PROPRIETOR OF EXPORT WAREHOUSE
GENERAL INSTRUCTIONS
A. Who prepares this report? Proprietors of export warehouses must prepare and file this report about their TTB permit operations.
B. When must I prepare this report? You must prepare and file this report at the following times.
(1) The month in which you start to engage in the business of a proprietor of an export warehouse and each following month, as long as you are engaged in the business.
You must file this report each month whether or not you conduct any business.
(2) When an appropriate TTB officer has required a special inventory.
(3) When you discontinue the business covered by your TTB permit.
C. When must I file this report? No later than 20 days after the end of the month that the report covers.
D. How do I file this form? Send the completed form to the Director, TTB National Revenue Center, 550 Main St., Ste. 8002, Cincinnati, OH 45202-5215. Keep a copy
for your records.
E. How do I enter quantities of articles on the report form? Each column heading states the unit of measure as either “number” or “pounds.” Where “number” is
indicated, enter the total number of individual sticks or units. For example, ten thousand small cigarettes would be entered as “10,000”. Do not enter the number of
packs, cartons or cases. Where “pounds” is indicated, enter quantity in pounds and fractions of a pound, rounded to two decimal places. For example, show ten pounds
four ounces as “10.25” - convert total ounces to pounds by dividing total ounces by 16.

INSTRUCTIONS FOR ITEMS ON THE FORM
F. Item 1 - What is my employer identification number? The nine-digit code that the Internal Revenue Service (IRS) has assigned to your business.
G. Item 2 - What is my TTB permit number? This "number" is listed on your TTB permit to conduct operations as a proprietor of an export warehouse. For example, EWXX-1234 where XX is the 2-letter State abbreviation of the U.S. Post Office. Each location at which you conduct operations has a "number". If you have more than one
TTB permit, you must file separate reports for each.
H. Item 3 - What time period(s) must my report cover?

I.

Report(s) for:

Time period(s):

Starting business

From the day and month that you start business to the last day of the same month

After starting business

Each month

Special inventory required by
appropriate TTB officer

(1) From the first day of the month to the day preceding the special inventory; AND
(2) From the day of the special inventory to the last day of the month

Discontinuing business

From the first day of the month to the day of the same month that you discontinue business

Item 13 – How do I report a loss (other than a shortage disclosed by an inventory)? Show on line 13 the quantity of articles lost and report the loss to TTB by contacting
the National Revenue Center (see contact information in instruction L below). To be relieved of liability for excise tax on tobacco products lost (otherwise than by theft) or
destroyed, by fire, casualty, or act of God, you must file a claim for remission of the tax liability using TTB F 5620.8. Your claim must include the nature, date, place, and
extent of the loss.

TTB F 5220.4 (03/2016) VERSIONS PREVIOUS TO 2009 SUPERSEDED AND MAY NOT BE USED

Instructions: Page 1 of 2

J. Item 14 – How do I report a shortage disclosed by an inventory? When required to take an inventory, you must report any shortages disclosed by that inventory on line
14 of the report covering the period during which the inventory was taken. If you do not voluntarily pay excise taxes on the amount of tobacco products or cigarette papers
and tubes shown as a shortage, TTB may send you a written notice instructing you to explain why an assessment of tax should not be made on the shortage.
K. Item 18 - Who may sign this report?
If your business is a

The report must be signed by:

Sole Proprietorship

(1) You; OR
(2) An individual for whom you have filed an ATF or TTB F 5000.8, Power of Attorney, that grants authority to sign this report

Partnership

(1) Each partner; OR
(2) The partner who has been given the authority to sign by the articles of partnership or similar agreement of all the partners that
you filed for this permit; OR
(3) An individual for whom you filed an ATF or TTB F 5000.8, Power of Attorney, that grants authority to sign this report

Corporation, association, limited
liability company, or other
business

(1) An individual who has signature authority granted by the business documents that you filed for this permit; OR
(2) An individual for whom you filed an ATF or TTB F 5000.8, Power of Attorney, that grants authority to sign this report

QUESTIONS.
L. If I have questions about this TTB form, who can answer my questions? Contact a specialist in the TTB Tobacco Excise Tax Group, National Revenue Center by
phone at 1-877-882-3277 or 1-513-684-7137, or by e-mail at ttbtobacco@ttb.gov.
RECORDS RETENTION. A copy of this report has to be kept for 3 years following the close of the calendar year covered in the report.

PAPERWORK REDUCTION ACT NOTICE
This information request is in accordance with the Paperwork Reduction Act of 1995. The purpose of this information collection is to monitor the operations of industries regulated
by TTB. TTB uses the information to monitor activities and determine errors or omissions on taxable commodities. The information is mandatory by statute (26 U.S.C. 5722).
The estimated average burden associated with this collection of information is 48 minutes per respondent or recordkeeper depending on individual circumstances. Comments
concerning the accuracy of this burden estimate and suggestions for reducing this burden should be addressed to: Reports Management Officer, Regulations and Rulings Division,
Alcohol and Tobacco Tax and Trade Bureau, 1310 G Street, NW., Box 12, Washington, DC 20005.
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 5220.4 (03/2016) VERSIONS PREVIOUS TO 2009 SUPERSEDED AND MAY NOT BE USED

Instructions: Page 2 of 2

OMB NO. 1513-0024
FOR TTB USE ONLY

DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)

AUDITED BY

REPORT - PROPRIETOR OF EXPORT WAREHOUSE
1. Employer Identification Number
(Read instruction F)

2. TTB Permit Number
(Read instruction G)

3. Report Covers Period of:
(Read instruction H)

―
6. Name and Address (as listed on TTB permit)

* Enter quantity in pounds and fractions of
a pound rounded to 2 decimal places.

Large Cigars (Number)
(a)

Small Cigars (Number)
(b)

DATE OF AUDIT

4.

This is the first report for this export
warehouse.

5.

This is a final report and I have attached my
permit OR my permit is not attached
because:

Large Cigarettes
(Number)
(c)

Small Cigarettes
(Number)
(d)

NO ENTRY

NO ENTRY

Chewing Tobacco
(Pounds)*
(e)

8.

a. From factories of manufacturers

Received Without
Payment of Tax:

7. On Hand Start of Period

b. From Customs custody

NO ENTRY

NO ENTRY

NO ENTRY

(1) Puerto Rico
(2) Other
c. From other export warehouses
d. From Foreign Trade Zones

9. Overages Disclosed by Inventory
10. Other (Specify):
11. TOTAL
Removed
W/o Tax Pymt

12.

a. To other export warehouses
b. To factories of manufacturers
c. To Foreign Trade Zones
d. Other exports

13. Loss Other Than Shortage by
Inventory (Read instruction I)
14. Shortages Disclosed by Inventory
(Read instruction J)
15. Other (Specify):
16. On Hand End of Period
17. TOTAL
TTB F 5220.4 (03/2016) VERSIONS PREVIOUS TO 2009 SUPERSEDED AND MAY NOT BE USED

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* Enter quantity in pounds and
fractions of a pound rounded to 2
decimal places.

Snuff
(Pounds)*
(f)

Pipe Tobacco
(Pounds)*
(g)

Roll-Your-Own
Tobacco
(Pounds)*
(h)

Cigarette Papers
(Number)
(i)

Cigarette Tubes
(Number)
(j)

NO ENTRY

NO ENTRY

NO ENTRY

Processed Tobacco
(Pounds)*
(k)

7. On Hand Start of Period

Received Without
Payment of Tax:

8.

a. Fro m factories of
manufacturers
b. From Customs custody

NO ENTRY

NO ENTRY

NO ENTRY

(1) Puerto Rico
(2) Other
c. From other export
warehouses
d. From Foreign Trade Zones

9. Overages Disclosed by Inventory
10. Other (Specify):
12.

a. To other export warehouses

Removed W/o
Tax Pymt:

11. TOTAL

b. To factories of
manufacturers
c. To Foreign Trade Zones
d. Other exports

13. Loss Other Than Shortage by
Inventory (Read instruction I)
14. Shortages Disclosed by Inventory
(Read instruction J)
15. Other (Specify):
16. On Hand End of Period
17. TOTAL
UNDER PENALTIES OF PERJURY, I DECLARE THAT, TO THE BEST OF MY KNOWLEDGE AND BELIEF, THIS REPORT IS TRUE, ACCURATE, AND COMPLETE.
18. Signature

19. Name and Title

20. Business Telephone Number

21. Business E-Mail Address

Send this form to the Director, TTB National Revenue Center, 550 Main St., Ste. 8002, Cincinnati, OH 45202-5215
TTB F 5220.4 (03/2016) VERSIONS PREVIOUS TO 2016 SUPERSEDED AND MAY NOT BE USED

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