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pdfDEPARTMENT OF THE TREASURY
OMB NO. 1513-0130 (xx/xx/xxxx)
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
REPORT OF REMOVAL, TRANSFER, OR SALE OF PROCESSED TOBACCO
General Instructions
A. Who must file this report? (1) With certain exceptions described in
Instruction B below, if you are a manufacturer of processed tobacco or
of tobacco products, you must use this form to report any proces-sed
tobacco you remove for export or for shipment to someone who does
not hold a TTB permit as a manufacturer of processed tobacco or of
tobacco products, as an importer of processed tobacco, or as an
export warehouse proprietor. (27 CFR 40.72(b), 40.202(b), and
40.522(d)(1)). (2) With the exceptions described in Instruction B
below, if you are an importer, you must use this form to report any
processed tobacco you export or that you transfer or sell to someone
who does not hold a TTB permit as an importer or manufacturer of
processed tobacco or of tobacco products or as an export warehouse
proprietor. (27 CFR 41.262(d)).
K. Items 10 through 12 – Enter the full name and business
address and telephone number of the purchaser (if there is a
purchaser) or the recipient (if there is no purchaser). Enter the
personal address and telephone number if the purchaser/recipient is
not a business.
L. Items 13 through 18 – Enter information as required by the
headings. Records supporting the information submitted on this
report must be maintained as required under 27 CFR 40.521(c) and
41.261(c).
M. Item 19 – Who may sign this report?
B. What removals, shipments, or transfers do not have to be
reported on this form? (1) If you are a manufacturer or importer, you
do not have to use this form to report removals of processed tobacco
for export if you have obtained prior written approval from the
appropriate TTB officer to report removals for export in a monthly
summary in a format approved by the appropriate TTB officer. (27
CFR 40.522(d)(2) and 41.262(d)(2)). (2) If you are a manufacturer of
tobacco products, you do not have to report any removal of samples of
processed tobacco removed for the purpose of soliciting orders of
tobacco products, any removal of processed tobacco for destruction or
for scientific testing or testing of equipment which results in the
destruction of the processed tobacco or the return of the processed
tobacco to the factory premises, or any removal of processed tobacco
for transfer between permitted premises of the same manufacturer.(27
CFR 40.522(d)(3)). (3) If you are an importer, you do not have to
report any shipment or transfer of processed tobacco for scientific
testing or testing of equipment which results in the destruction of the
processed tobacco or the return of the processed tobacco. (27 CFR
41.262(d)(3)).
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 of this report for your records.
Specific Instructions
E. Item 1 – The Employer Identification Number is the nine-digit code
that the Internal Revenue Service (IRS) has assigned to your
business.
F. Item 2 – The TTB permit number is listed on your TTB permit. For
example, a permit to manufacture processed tobacco would have a
number such as “MP-XX-1234,” where XX is the 2-letter State abbreviation. If you have more than one TTB permit, file separate reports
for each permit.
G. Item 3 – Each report must have a unique serial number. The first
report of the calendar year is “1” and each subsequent report should
be numbered in chronological order.
H. Items 4 and 5 – Show in item 4 the date of the removal, sale, or
transfer. Show in item 5 the date of the report.
I. Item 6 – Show the name and premises address as it is shown on your
TTB permit.
J. Items 7, 8, and 9 – Enter a description of the type of processed
tobacco that was removed, sold, or transferred (using descriptions
such as “loose cut rag tobacco”); enter the number and size of transport containers (such as 20 boxes, 50 pounds each); and enter the net
total quantity of tobacco, stated in pounds (such as “500 pounds”).
TTB F 5250.2 (08/2018)
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.
(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 have filed an ATF or
TTB F 5000.8, Power of Attorney, that grants
authority to sign this report.
Partnership
Corporation,
Association,
Limited Liability
Company, or
other business
C. When must I file this report? If you are a manufacturer, you must file
this report by the close of the business day on the day following the
removal. If you are an importer, you must file this report by the close
of the next business day following the day of exportation, transfer, or
sale.
If your business
is a
(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 have filed an ATF
or TTB F 5000.8, Power of Attorney, that grants
authority to sign this report.
Paperwork Reduction Act Notice
This request is in accordance with the Paperwork Reduction Act of 1995. We use
this information collection to track shipments of processed tobacco and to take
action to investigate or prevent diversion of processed tobacco for use in illegal,
unpermitted manufacture of tobacco products. This information collection is
required by regulation under the authority of 26 U.S.C. 5722. We estimate that, on
average, it will take you 30 minutes to complete this form. You may require more or
less time depending upon your individual circumstances. Address your comments
concerning the accuracy of this burden estimate and suggestions to reduce this
burden 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.
Privacy Act Information
The following information complies with Section 3 of the Privacy Act of 1974
(5 U.S.C. 552a(e)(3)):
1. What is TTB’s authority to ask for this information? This information is
required by regulations issued under the authority of 26 U.S.C. 5722.
2. What is the purpose for this information collection? This information
collection helps TTB protect the revenue by providing information used to identify
and prevent the diversion of processed tobacco for use in illegal, unpermitted
manufacture of tobacco products.
3. How does TTB routinely use this information? We use this information
collection to track shipments of processed tobacco from TTB-permitted
manufacturers and importers to entities that do not hold TTB permits, including
foreign buyers. This information is used to investigate and prevent diversion of
processed tobacco for use in illegal, unpermitted manufacture of tobacco products.
4. What is the effect if I do not supply the information TTB requests? Without
the information required by this collection, TTB would be severely hampered in its
ability to track processed tobacco shipments made by TTB permit holders to
persons who do not hold such permits. Such tracking is necessary to prevent
processed tobacco, which is not subject to Federal excise tax, from being diverted
for use in the illegal, unpermitted manufacture of tobacco products, which are
subject to that tax.
Page 1 of 2
OMB NO. 1513-0130 (xx/xx/xxx)
DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)
REPORT OF REMOVAL, TRANSFER, OR SALE OF PROCESSED TOBACCO
PART I – PERMIT HOLDER INFORMATION
1. Employer identification number (Read instruction E):
2. TTB permit number (Read
instruction F):
3. Serial number (Read
instruction G):
―
4. Date of removal, sale, or transfer (mm/dd/yyyy):
6. Name and premises address:
5. Date of this report (mm/dd/yyyy):
PART II – TYPE AND QUANTITY OF PROCESSED TOBACCO TRANSFERRED
7. Description of processed tobacco:
8. Number of transporting containers and weight
of processed tobacco in each:
9. Total quantity
transferred (pounds):
PART III – IDENTIFICATION OF PURCHASER
AND OF PERSON DELIVERING PROCESSED TOBACCO
10. Full name of purchaser/recipient of
processed tobacco:
12. Telephone number:
11. Business address of the
purchaser/recipient:
(
13. Destination street address of the processed tobacco (if different than Item 10 – if same, check
box below):
)
―
15. Business phone number at
destination (if same as Item
12 check box below):
(
Same as Item 11
)
―
Same as Item 12
16. Name and business address of person picking up the processed tobacco for
delivery:
17. Identification (number of driver’s license or other
government-issued picture ID) for person listed
in Item 16:
18. License plate/tag number of vehicle:
PART IV – TRANSFERRING PERMIT HOLDER’S CERTIFICATION
Under penalty of perjury, I declare that I have examined this report and, to the best of my knowledge and
belief, the information presented in this report is true, correct, and complete.
19. Signature
TTB F 5250.2 (08/2018)
20. Title
21. Date Signed
Page 2 of 2
File Type | application/pdf |
File Title | Microsoft Word - 021813 TTB F 5250.2 (0130).docx |
Author | tpdevanney |
File Modified | 2018-07-26 |
File Created | 2013-02-19 |