Form TTB F 5110.31 TTB F 5110.31 Application and Permit to Ship Puerto Rican Spirits to t

OMB No. 1513-0043 (xx/xx/xxxx)
1. SERIAL NUMBER

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

APPLICATION AND PERMIT TO SHIP PUERTO RICAN SPIRITS TO THE UNITED STATES
WITHOUT PAYMENT OF TAX
(SeeInstructions
Instructionsononerse
Page 2)
See
PART I - APPLICATION
To The Secretary of the Treasury of Puerto Rico
Application is made to ship distilled spirits of Puer to Rican manufacture to the United States f or transfer from customs custody, under the provision of
26 U.S.C. 5232 to:

2B. AT (Number, street, city State and ZIP Code)

2.

PLANT NUMBER DSP 2A. OPERATED BY

3.

DISTRICT DIRECTOR, PUERTO RICO OPERATIONS, ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (Address)

4. DESCRIPTION OF SPIRITS
FORMULA (If any)

4. DESCRIPTION OF SPIRITS

CONTAINER
KIND
(a)

AGE
(b)

NUMBER
(c)

KIND
(d)

SERIAL
NUMBERS
(e)

5.

PRODUCED OR RECTIFIED BY (Name and address)

6.

TO BE SHIPPED BY (Name of vessel)

FORM
NUMBER
(f)

SERIAL NUMBER
(If any)
(g)

7.

DATE
APPROVED
(h)

PROOF1
(i)

PROOF
GALLONS
(j)

TO (Port of arrival in U.S.)

Under penalties of perjur y, I declare that this application and the statements therein have been examined by me and, to the best of my knowledge and
belief, are true, correct, and complete.
8.

DATE

9.

9A. BY (Signature and Title)

APPLICANT

PART II - CERTIFICATE OF REVENUE AGENT2
To The Secretary of the Treasury of Puerto Rico
I certify that the statements in P art I are tr ue and correct and that I have inspected and gauged the spirits described therein as follows:
10.
CONTAINER
KIND OF
PROOF
SPIRITS
GALLONS
SERIAL NUMBERS
NUMBER
KIND
(a)
(e)
(d)
(b)
(c)

11. SERIAL NUMBERS OF GOVERNMENT SEALS USED 3 12. DATE

13. SIGNATURE OF REVENUE AGENT

PART III - PERMIT TO SHIP
Permit is hereby granted to the applicant designated in item 10 to ship to the United States the spirits described above.
14. DATE
15. SECRETARY
15A. BY (Signature and Title)

TTB F 5110.31 (08/2018)

Page 1 of 2

PA RT IV - CERTIFICATE OF CUSTOMS AND BORDER PROTECTION OFFICER AT PORT OF ARRIVAL IN THE UNITED STATES
I certify that the spirits described before were received and have been inspected and w ere released, as follows:
17. PROOF GALLONS RELEASED
16. RESULTS OF INSPECTION (See instruction 6)

18. PORT OF

19. SEALS ON CONVEYANCE INTACT ON ARRIVAL4
YES

21. DATE

20. REMARKS

NO

22. SIGNATURE AND TITLE OF CUSTOMS AND BORDER PROTECTION OFFICER

PART V - CERTIFICATE OF RECEIPT
23. GAUGE OF SPIRITS RECEIVED IN BULK RWKHUWKDQLQEDUUHOVGUXPVRUVLPLODUSDFNDJHV

TANK NO.

PROOF

OTHER ELEMENTS OF GAUGE

GAIN

PROOF GALLONS

24. UNDER PENALTIES OF PERJURY, I DECLARE
THAT THE SPIRITS DESCRIBED WERE
RECEIVED, EXCEPT AS NOTED ON THIS
FORM OR ON ACCOMPANYING PACKAGE
GAUGE RECORD, AND WERE RECORDED IN
MY:
PRODUCTION
ACCOUNT

LOSS

25. DATE RECEIVED 26. PROPRIETOR

PROCESSING
ACCOUNT

STORAGE ACCOUNT
FOOTNOTES

1

Show proof only if spirits are in bulk containers other than barrels , drums, or similar packages.
If spirits are in barrels, drums, or similar packages, prepare a package gauge record in quintuplicate .
3
If in tanks or v ans.
4
If seals on tanks or v ans are not intact, explain under “Remarks” and record the ser ial number(s) of any Customs seal(s) affixed.
2

INSTRUCTIONS
5. DISPOSITION BY CONSIGNOR. On receipt of the approved forms
1. GENERAL. The consignor must make application on TTB F 5110.31
from the Secretary, the consignor will retain one copy of TTB F 5110.31
(original and 5 copies) for each consignment. Separate applications must
and any accompanying package gauge records, dispatch one copy
be filed for shipments in barrels, drums, or similar packages, and
of each on the vessel concerned for the guidance of the Customs
for shipments in bulk conveyances. Only spirits produced under one
officer who will inspect the cargo at the port of arrival in the United
formula may be shown on the same TTB F 5110.31. The serial number
States, and forward the remaining copies of each, by mail, to the
shown in Item 1 must be prefixed by the last two digits of the calendar
District Director of Customs at the port of arrival in the United States.
year, e.g., “09-1.”
2. PART I. The consignor must complete Part I of TTB F 5110.31 and
deliver all copies to the revenue agent. The address of the District
Diretor, Puerto Rico Operations of the consignee’s region must be
entered in item 3. Contact 1-877-882-3277 for information on where
to send this form.
3. PART II. The revenue agent must determine that the spirits are
properly described in Part I and must gauge the spirits. After executing
the certification in Part II, the revenue agent will retain one copy of
TTB F 5110.31 and of the package gauge record, if any, and forward
the remaining copies to the Secretary.
4. PART III. If the application is in order, the Secretary will complete
Part III, retain one copy of TTB F 5110.31 and any accompanying
package gauge record and return the remaining copies of each form to
the consignor.

6. PART IV. On receipt of all copies of the TTB F 5110.31 and any related
package gauge record, the Customs officer must inspect the shipment
and report the results on TTB F 5110.31, Part IV. If the seals on bulk
containers are intact, the shipment will be released. If the seals are not
intact, they must, before release of the shipment, be replaced by
Customs seals. Each barrel, drum, or similar package, which appears
to have sustained a loss, must be weighed and reported on the
package gauge record in triplicate. On completing the inspection, the
Customs officer will execute his certification on all copies of TTB F 5110.31.
He/She will retain one copy of TTB F 5110.31 and any related package
gauge record. On release of the spirits, the Customs officer will forward
the original and remaining copies of each form to the consignee.
7. PART V. The consignee will complete Part V of TTB F 5110.31, retain
the copy and the copies of each package gauge record and forward the
original of each form to the Director, TTB National Revenue Center.

PAPERWORK REDUCTION ACT NOTICE
This request is in accordance with the Paperwork Reduction Act of 1995. This information collection is used to make a determination of the eligibility of
the person to withdraw and use taxable commodities on which tax has not been paid. The collected information is requested under the authority of the
Internal Revenue Code at 26 U.S.C. 5232, 5314, and 7652.
The estimated average burden associated with this collection of information is 45 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 the 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.

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TTB F 5110.31 (08/2018)