Contact Name (This should be the name of the person to contact with application-related issues) Address (see Section V 2.a.vi.

Transcription

1 State f Flrida Department f Business and Prfessinal Regulatin Divisin f Alchl Beverages and Tbacc Applicatin fr Brand/Label Registratin Frm # 1 f 5 If yu have any questins r need assistance in cmpleting this applicatin, please cntact the Department f Business and Prfessinal Regulatin, Custmer Cntact Center, at Fr fees, instructins, and additinal infrmatin see pages 3-5, f this applicatin. Sectin I Registrant Infrmatin REGISTRANT INFORMATION [4011/1030] Is this yur first time Yes (Cmplete this entire sectin) registering brands/labels? N (Cmplete nly the Registrant Name and License # fields. Yu must als cmplete any fields where the infrmatin has changed.) Registrant Name License # Business Type: Manufacturer Distributr Imprter Bttler Brewer Vintner Winery Rectifier Legally Authrized Exclusive Agent Other (please specify): CONTACT INFORMATION Are yu updating this infrmatin? Yes N Cntact Name (This shuld be the name f the persn t cntact with applicatin-related issues) Cmpany Name (If different than registrant) Phne Number Address (see Sectin V 2.a.vi.) Street Address r P.O. Bx City State Zip Cde (+4 ptinal) Cunty (if Flrida address) Cuntry Brand/Label Registratin Incrprated by Rule:

2 1 Sectin II Brands/Labels t Be Registered attached additinal cpies as necessary TTB # (if applicable) BRAND/LABEL REGISTRATION INFORMATION Nte Please see the Sectin V 2.b. f the Instructins n pages 4-5 befre cmpleting this sectin Malt types nly Brand/Label Type Check nly ne bx belw Brand/Label Names Label Included Malt 1040] Wine 1050] Spirit 1060] Other* 1070] FL/Flrida Exemptin FL Flrida 2 f 5 If FL r Flrida checked, specify the lcatin f FL/Flrida Imprinting *Please see the instructins fr the descriptin f beverages that make up the Other type Brand/Label Registratin Incrprated by Rule:

3 Sectin III Brand/Label Registratin Fee Ttals BRAND/LABEL REGISTRATION FEE INFORMATION Nte Please see the Sectin V 2.c. f the Instructins n page 5 befre cmpleting this sectin Brand/Label Type Malt Wine Spirit Other Ttal Cunt f Brand/Label Type in Sectin II Individual Brand/Label Registratin Fee x $30 x $15 x $30 x $0 Ttal Brand/Label Registratin Fee by Type 3 f 5 Sectin IV Oath/Affirmatin Statement OATH/AFFIRMATION Wine registrants: Distilled Spirit registrants: Malt beverage registrants: Must be either the manufacturer r the legally authrized exclusive agent. Brands registered, including cider, are in cntainers apprved by the Federal gvernment that d nt exceed ne (1) galln. Must be either the manufacturer r the legally authrized exclusive agent. Brands registered are in cntainers apprved by the Federal gvernment that d nt exceed 1.75 liters (59.18 unces). Must be currently registered with the Flrida Department f State. Must have current exclusive sales territry agreements n file with the divisin. Brands registered must either bear the wrd Flrida r FL r have been exempted in accrdance with s (5), F.S. Brands registered are in cntainers f 32 unces r less r packaged in bulk r in kegs r barrels r in a cntainer hlding ne (1) galln r mre, regardless f cntainer type. Registrant understands that recrds are subject t audit t verify cmpliance with the beverage law. Under penalties f perjury, I declare that I have read the freging Applicatin and that the facts stated in it are true. Signature: Print Name: Knwingly making a false declaratin abve cnstitutes the crime f perjury by false written declaratin, a felny f the third degree, punishable as prvided in ss , , , F.S. Date : APPLICATION CHECKLIST IMPORTANT Submit all items n the checklist belw with yur applicatin t ensure faster prcessing. APPLICATION Brand/Label Registratin APPLICATION REQUIREMENTS Cmplete this entire applicatin. Submit Fees: $30 fr each Malt type being registered $15 fr each Wine type being registered $30 fr each Spirit type being registered $0 fr each Other type being registered Submit an riginal label r a legible cpy fr each brand/label being registered. Please mail yur cmpleted applicatin, dcumentatin and required fee(s) t: Department f Business and Prfessinal Regulatin 2601 Blair Stne Rad Tallahassee, FL Brand/Label Registratin Incrprated by Rule:

4 Sectin V Instructins If yu have any questins r need assistance in cmpleting this applicatin, please cntact the Department f Business and Prfessinal Regulatin, Custmer Cntact Center, at f 5 1. General Requirements fr Brand/Label Registratin a. Pay a fee fr each brand/label being registered i. $30 each fr Malt beverage. ii. $15 each fr Wine beverage. iii. $30 each fr Spirit beverage. b. There is n charge fr registratin as the Primary American Surce. c. Submit an riginal r legible cpy f the beverage label. d. Registrant recrds are subject t audit t verify cmpliance with the beverage law. e. Fr Malt brand registratin: i. The registrant must be currently registered with the Department f State. ii. Malt beverage exclusive sales territry agreements are n file with the divisin. iii. Malt beverages registered either bear the wrd Flrida r FL r have been exempt in iv. accrdance with s (5), F.S. The malt beverage must be held in cntainers f 32 unces r less r packaged in bulk r in kegs r barrels r in a cntainer hlding ne (1) galln r mre, regardless f cntainer type. f. Fr Wine/Spirit label registratin: i. Registrant fr wine r spirits must be either the manufacturer r the legally authrized exclusive agent. ii. iii. Wine, including cider, must be held in cntainers apprved by the Federal gvernment that d nt exceed ne (1) galln. Distilled spirit must be held in cntainers apprved by the Federal gvernment that d nt exceed 1.75 liters (59.18 unces). 2. Applicatin Instructins (by sectin) a. Sectin I i. Registrant Name: (1) Fr Malt beverages, Registrant Name is the name f the manufacturer, brewer, bttler, distributr r imprter. (2) Fr Wine and Spirits, Registrant Name is the name f the Primary American surce f supply, meaning the manufacturer, vintner, winery, rectifier, bttler, r their legally authrized exclusive agent. ii. If yu are a registrant wh has previusly submitted an applicatin fr brand/label registratin and sme f the infrmatin has changed, then yu must cmplete the necessary fields with the updated infrmatin. iii. Address fields are fr the mailing address and all registrant crrespndence frm the department will be sent t this address. iv. Cntact name is the persn cmpleting the applicatin and will be the individual cntacted regarding any applicatin questins. This may be an individual that wrks fr the registrant, an fficer, partner r wner fr the registrant, r it culd be a cmpliance cmpany that is under cntract with the registrant t perfrm applicatin related tasks. v. Cmpany name shuld be cmpleted if the applicatin is being prepared by smene ther than the registrant and/r an emplyee f the registrant, that is, cmpliance cmpany. vi. Please prvide yur address. Fr cmpliance cmpanies, please prvide a unique address fr each registrant. b. Sectin II i. Enter the TTB number, if Federal brand/label registratin is required, f each brand/label yu are registering in the TTB # clumn. (1) Leave TTB number blank if Federal brand/label registratin is nt required, fr example, beer with n malt cntent, malt beverage brewed in Flrida that is nt shipped in interstate cmmerce, r wine f less than 7% alchl. ii. Enter the name f each brand/label yu are registering in the Brand/Label Names clumn. Brand/Label Registratin Incrprated by Rule:

5 5 f 5 iii. Check the bx under Label Included clumn t indicate that yu have submitted the label with this applicatin. iv. Brand/label types are defined as fllws: (1) Malt (a) All brewed beverages cntaining malt with a half percent r mre (>= 0.5 %) f alchl by vlume. (b) This type includes malt beverages brewed in Flrida that will nly be shipped within Flrida. (2) Wine (a) All beverages made frm fresh fruits, berries, r grapes, either by natural fermentatin r by natural fermentatin with brandy added, in the manner required by the laws and regulatins f the United States. (b) Includes all sparkling wines, champagnes, cmbinatin f the afresaid beverages, vermuths, and like prducts. (3) Spirits (a) All beverages made frm the substance knwn as ethyl alchl, ethanl, r spirits f wine in any frm, including all dilutins and mixtures theref frm whatever surce r by whatever prcess prduced. (4) Other (a) Wine r Cider beverages with less than 7% alchl cntent. (b) Beer beverages with n malt. (c) Wine r Spirits beverages prduced and shipped nly in Flrida. v. Fr the clumns labeled Malt types nly (gray shading): (1) This area applies t Malt types nly. (2) Check the bx under the FL/Flrida Exemptin clumn if the malt brand yu are registering is exempt frm the FL/Flrida imprinting requirements. (a) If checking this bx, d nt cmplete the ther three clumns. (b) The manufacturer must have been apprved fr the FL/Flrida imprinting exemptin prir t submitting this applicatin. (3) If the malt brand yu are registering is nt exempt, then yu must check the bx under either the FL r Flrida clumns, depending n the wrding used n the label. (4) In the Lcatin f FL/Flrida Imprinting clumn, describe where n the cntainer the FL r Flrida wrding is lcated, e.g., main label, bttle neck, bttle cap, etc. c. Sectin III i. Cunt the ttal brand/label by type being registered frm Sectin II. ii. Multiply these amunts by the registratin fee indicated in the applicatin t calculate the ttal fee by type. iii. Ttal the registratin fees t calculate the ttal amunt necessary t register all f the brands/labels. d. Sectin IV i. Applicant must sign the Oath/Affirmatin statement. 3. Other Infrmatin a. Applicatins typically will be reviewed within 7 t 10 wrking days. b. An incmplete applicatin will result in a letter sent t the address indicated in Sectin 1. c. Applicants will receive a listing f the brands / labels apprved. Brand/Label Registratin Incrprated by Rule: