TTB F 5200.16 Application for Amended Permit to Manufacture Tobacco Pr

OMB No. 1513-0078
FOR TTB USE ONLY

DEPARTMENT OF THE TREASURY

ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)

Number

APPLICATION FOR AMENDED PERMIT TO MANUFACTURE
TOBACCO PRODUCTS OR PROCESSED TOBACCO OR TO
OPERATE AN EXPORT WAREHOUSE
1.

This application is submitted to request an amendment to my TTB permit number

2.

Manufacturer of Tobacco Products
Name and address shown on my permit:

4.

Date

to conduct business as a:

Manufacturer of Processed Tobacco
Proprietor of an Export Warehouse
3.
My employer identification number is (Read instruction F):

I have attached my permit to this TTB form for amendment (Read instruction G).
OR
I have NOT attached my permit to this application because:

5. a.
b.

I have changed my legal name (Read instruction H)
I am removing or adding trade name(s) as follows: (Read instructions I and J)
Remove trade name(s) from my permit:
Add trade name(s) to my permit:
I have attached the document(s) to show this change (such as amended articles of incorporation or trade name certificate).

c.
OR
d.

I have NOT attached the document(s) to show this change because:
I am reporting that the mailing address of my premises has changed (but not its physical location). My new Mailing address:

6.

7. a. I intend to

relocate

extend, or

curtail the premises where I manufacture tobacco products. (Read instruction K)

b. I intend to

relocate

extend, or

curtail the premises where I manufacture processed tobacco. (Read instruction K)

c. I intend to

relocate

extend, or

curtail my export warehouse premises.(Read instruction L)

d.

e.
8.

I have attached a description and, if necessary, a diagram of my tobacco products factory or export warehouse or processed
tobacco premises.
I have NOT attached a description or diagram for the following reason:
I declare that I have read the instructions for this form including the need to file other TTB forms. I understand that I may need to
file these TTB forms before TTB may act on this application. I understand that this application includes the information that I have
attached to this form or to which I have made a reference. I understand that an appropriate TTB officer may require additional
information to determine that I am entitled to the amended permit for which I am applying. Under penalties of perjury, I have
examined this application, and to the best of my knowledge and belief, this application, including any attachments, is true, correct,
and complete.

a. Signature (See instruction M)
e. My E-mail Address

b. Printed Name

c. Title

d. Date

e. My Business Telephone Number

Send this form to: Director, TTB National Revenue Center, 550 Main Street, Suite 8002, Cincinnati, OH 45202
TTB F 5200.16 (04/2016) VERSIONS PREVIOUS TO 02/2013 ARE SUPERSEDED AND MAY NOT BE USED.

DEPARTMENT OF THE TREASURY

ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)

APPLICATION FOR AMENDED PERMIT TO MANUFACTURE TOBACCO PRODUCTS OR
PROCESSED TOBACCO OR TO OPERATE AN EXPORT WAREHOUSE
(INSTRUCTIONS)
1. GENERAL
A.

Why do I need this form? Use this form to amend your permit to manufacture tobacco products or to manufacture processed
tobacco or to operate an export warehouse under Chapter 52 of Title 26 of the United States Code (Internal Revenue Code).
Applying for an amended permit does not authorize you to operate contrary to any Federal, State, or local laws.

B.

When do I have to file this form to amend my permit and do I have to wait for TTB to approve it?
1) You must file this form if you:
a)
b)

When do I file the application?

When may I make the
change?
Wait for TTB Approval
TTB approval not required
before the change

Which form item do I
complete?
Item 7
Item 6

Before extending or curtailing

Wait for TTB Approval

Item 7

Within 30 days

TTB approval not required
before the change
TTB approval not required
before the change

Items 5a and 5c

Before you relocate
Within 30 days of the change

d)

Relocate your permit operations
Change the address of your
Permit operations (not the
physical location)
Extending or curtailing your
premises
Change your legal name

e)

Add or remove trade names

Within 30 days

c)

2) You are NOT required to file this
form if you:
a)
Have a change in ownership of
the business covered by your
TTB permit
b)
Change in officers or directors of
a corporation
c)
Change in stock ownership

d)

C.

What do I file with TTB?

Items 5b and 5c

When may I make the change

TTB F 5200.3 – change in ownership
requires the new owner to apply for a
new permit
A letter notice reporting the change

Wait for TTB Approval

i. Controlling interest

TTB F 5200.3 – change in ownership
requires the new owner to apply for a
new permit

ii. Person(s) holding more
than10% interest
Have a change in limited liability
company membership

A letter notice reporting the change

If TTB F 5200.3 is filed within 30 days,
operations may continue under current
permit until new application is acted upon by
TTB
TTB approval not required before the
change
TTB will advise whether further filings are
required. Changes that involve actual or
legal control of the business require filing for
a new permit using TTB F 5200.3

A letter notice reporting the change

TTB approval not required before the
change

How do I file this form? Send this form to:
Director, TTB National Revenue Center, 550 Main Street, Ste. 8002, Cincinnati, OH 45202.
We recommend that you keep a copy of what you send.

D.

Can I incorporate information that TTB already has on file? Yes, if you include, from the item(s) filed:
1) The name, address and TTB permit number that appears on the TTB form referenced;
2) The TTB form and item number; and
3) The date that the TTB form was signed.

E.

What if there is not enough space for my information? Attach a separate sheet with any additional information.
On this form in the space provided next to the item number, state that you have attached a separate sheet. Any attachment to this
form must include this TTB form number (TTB F 5200.16) and the item number(s) to which the information corresponds.

TTB F 5200.16 (04/2016) VERSIONS PREVIOUS TO 02/2013 ARE SUPERSEDED AND MAY NOT BE USED. Instructions Page 1 of 3

DEPARTMENT OF THE TREASURY

ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)

APPLICATION FOR AMENDED PERMIT TO MANUFACTURE TOBACCO PRODUCTS OR
PROCESSED TOBACCO OR TO OPERATE AN EXPORT WAREHOUSE
(INSTRUCTIONS)
SPECIFIC ITEMS
F.

Item 3. What is my employer identification number? This is the nine-digit code that the Internal Revenue Service (IRS)
assigns to your business. If you do not have an employer identification number, you may obtain one by filing an IRS Form SS-4.
You may get this form from the IRS. You may also obtain an EIN by applying online at www.irs.gov.

G.

Item 4. When do I have to attach my permit? You must always attach your permit. If you cannot locate your permit, you must
state this fact.

H.

Item 5.
1) What is my legal name?
Your business is a:
Sole Proprietorship
Partnership
Corporation, association, limited liability
company, or other business
organization

Your legal name is:
Your full name.
The name of each partner or the name of the partnership as filed with a State or
local government.
The name as stated on your documents filed with the State or local government.

2) What documents must I file?
If your business is a:
Attach to this application:
Accurate copy of certificate, issued by State, county, or municipality, which shows the change
Sole Proprietorship
in your name.
Accurate copy of articles OR the certificate required to be filed by any State, county, or
Partnership or
Association
municipality.
Accurate copy of the corporate charter OR certificate of corporate existence or incorporation, or
other corporate document that shows your new legal name.
Corporation
This copy must be executed by the appropriate officer of the State in which your business is
incorporated.
Accurate copy of the business document(s) that shows your new legal name filed with a State,
Limited Liability Company
county, or municipality when such filing is required.
or other business
organization
The copy must show that it was filed with the appropriate government agency.
I.

Item 5. What is a trade name? In general, a trade name is used to identify your business that is not its legal name.
For example, your legal name may be ABC Corporation, but you use ABC Tobacco Products in your business operations.
Business operations include any name with which you identify your business on invoices or letterhead. Also, business operations
include a name that identifies your business on packages of tobacco products or cigarette papers and tubes.

J.

Item 5. Am I required to have a trade name certificate? Your State, county, or municipal authority may require a trade name
certificate to operate your business under a trade name. If your State, county, or municipal authority does not require a trade
name certificate, state this fact in item 5c.

K.

Item 7. Relocation, extension or curtailment of manufacture tobacco products and factory or export warehouse:
1) What must I include in my description of my manufacture tobacco products and factory or export warehouse?
State the number, street, city, and State of the location of your factory or export warehouse premises to be covered by your
permit.
2) When must I attach a diagram of my premises?
(a) Your factory or export warehouse or processed tobacco premises is more than one building and each building
cannot be identified by a separate street address. Identify each building by a letter, number, or similar designation.
(b) Your factory or export warehouse or processed tobacco premises uses only a part of a building. Show the floor
and room(s) in the building.
(c) Your tobacco products factory adjoins a retail store. Show any doors or other openings between the factory and the retail
store.

TTB F 5200.16 (04/2016) VERSIONS PREVIOUS TO 02/2013 ARE SUPERSEDED AND MAY NOT BE USED. Instructions Page 2 of 3

DEPARTMENT OF THE TREASURY

ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)

APPLICATION FOR AMENDED PERMIT TO MANUFACTURE TOBACCO PRODUCTS OR
PROCESSED TOBACCO OR TO OPERATE AN EXPORT WAREHOUSE
(INSTRUCTIONS)
L.

Item 8. Who may sign this application?
If your business is a:
The application must be signed by:
Sole Proprietorship

You; OR
An individual for whom you have filed an ATF or TTB F 5000.8, Power of Attorney.
Each partner; OR

Partnership

Corporation,
Association, Limited
Liability Company, or
other business
organization

The partner who has been given the authority to sign by the articles of partnership or similar
agreement of all the partners that you have filed for this permit; OR
An individual for whom you filed an ATF or TTB F 5000.8, Power of Attorney.
An individual who has signature authority granted by the business documents that you have
filed for this permit or documented using TTB F 5100.1, Signing Authority for Corporate or LLC
Officials; OR
An individual for whom you have filed an ATF or TTB F 5000.8, Power of Attorney

M.

If I have questions about this TTB form, who can answer my questions? Contact a specialist at the TTB National Revenue
Center by phone at 1-877-882-3277, fax at 1-202-453-2338, or e-mail to ttbtobacco@ttb.gov.

N.

When can I expect my permit? In general, it takes from 8 to 12 weeks before TTB decides on amending your permit. TTB
thoroughly examines the information that you provide with this application. If you omit information or provide partial information, it
will take longer. Also, TTB may request additional information based on the information that you have provided. If TTB decides not
to issue the amended permit, you will receive a written notice stating the reasons.

PAPERWORK REDUCTION ACT NOTICE
This request is in accordance with the Paperwork Reduction Act of
1995. We use this information collection to determine your
identity, location, extent of operations, and eligibility to engage in
operations, and the likelihood that you will conform with Federal
laws and regulations. This information is required from you to
obtain or retain a benefit and is mandatory by law (26 U.S.C.
5712).
We estimate that you will spend 1 hour to complete this form
(average burden associated with this collection of information).
You may spend 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.

1.

What is TTB’s authority to ask for this information? We
require this information under the authority of 26 U.S.C.
5712. You must provide this information before TTB decides
on whether you may continue your business allowed under
this permit.

2.

What is the purpose for this information collection? You
must provide this information so that TTB will be able to
determine your identity, location, extent of operations, and
eligibility to engage in operations, and the likelihood that you
will conform with Federal laws and regulations.

3.

How does TTB routinely use this information? We use this
information to make determinations for the purposes
described in paragraph 2.
Also, if we are not prohibited by law, we may disclose the
information that you provided on this form to other Federal,
State, foreign, or local law enforcement or regulatory agency
personnel, and to members of the public to verify it. Finally,
we may disclose this information to the Justice Department if
it appears that false information, which constitutes a violation
of Federal law, has been provided.

An agency may not conduct or sponsor a collection of information
unless it displays a current valid OMB control number. In addition,
you are 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)):

4.

What is the effect if I do not supply the information TTB
requests? If you fail to supply this information, then it will
delay TTB’s determination as described in paragraph 2. Also,
TTB may disapprove your application if you fail to supply the
information.

TTB F 5200.16 (04/2016) VERSIONS PREVIOUS TO 02/2013 ARE SUPERSEDED AND MAY NOT BE USED. Instructions Page 3 of 3