TTB F 5600.36 Statement of Manufacturer's Vendee (For Exports)

OMB No. 1513-0128

DEPARTMENT OF THE TREASURY

ALCOHOL AND TOBACCO TAX AND TRADE BUREAU

STATEMENT OF MANUFACTURER’S VENDEE (FOR EXPORTS)

(To support tax-free sales of taxable articles to a purchaser for export or for resale to a second purchaser for export
(section 4221(a)(2) of the Internal Revenue Code).)
The undersigned, or the

of which

(Name of manufacturer's vendee if other than undersigned)

I am

holds certificate of registry No.

,

(Title)

issued by the TTB Director, National Revenue Center at

.
(city and State)

The article or articles specified below or on the reverse side hereof were purchased tax-free by me or by
(Name of manufacturer’s vendee if other than undersigned)

on

,
(Date)

and were thereafter exported.
The undersigned or

has in my/its

(Name of manufacturer’s vendee if other than undersigned)

possession proof of exportation in respect of such article or articles. The evidence of export available is
and is located at
(State type of proof of exportation)

.
(If other than address below)

Such proof of exportation will be retained by

for at
(Name of manufacturer's vendee)

least 3 years from the date of this statement and will be made readily available for inspection by TTB officers.
I have not previously executed a statement in respect of the article or articles covered by this statement, and I
understand that the fraudulent use of this statement will subject me and all parties making such fraudulent use of this
statement to all applicable criminal penalties under the Internal Revenue Code.
SIGNATURE

PRINTED NAME

DATE

ADDRESS

PAPERWORK REDUCTION ACT NOTICE
This request is in accordance with the Paperwork Reduction Act of 1995. In some cases, persons who sell firearms or ammunition taxfree use specific statements to support the tax-free sales. In addition, a specific statement from the ultimate vendor to support claims
for certain tax refunds or credits is required. This form contains all required information for a properly executed statement. This is
being provided to promote uniformity among excise taxpayers and eliminate the need for taxpayers to design their own statements.
The information requested is required by Title 27, Code of Federal Regulations, Part 53.
We estimate the average burden associated with this collection of information is 45 minutes per respondent or recordkeeper, depending
on 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
TTB may not conduct or sponsor and you are not required to respond to, a collection of information unless it displays a current, valid
OMB control number.
TTB F 5600.36 (07/2010)