<uploaddata agency_id="914" agency_form_control_number="TTB F 5110.11" form_revision_name="ATF 5110 11 v5">
	<page1>
		<RETURN_FINAL>0</RETURN_FINAL>
		<BUSINESS></BUSINESS>
		<DBA></DBA>
		<ADDRESS></ADDRESS>
		<CITY></CITY>
		<STATE></STATE>
		<ZIP_CODE></ZIP_CODE>
		<PERMIT_NUMBER></PERMIT_NUMBER>
		<LINE5></LINE5>
		<LINE21></LINE21>
		<UNDER160_ONHAND></UNDER160_ONHAND>
		<UNDER160_DEP_BULK></UNDER160_DEP_BULK>
		<UNDER160_RECEIVED></UNDER160_RECEIVED>
		<UNDER160_RET_BULK></UNDER160_RET_BULK>
		<UNDER160_5></UNDER160_5>
		<UNDER160_TOTAL1></UNDER160_TOTAL1>
		<UNDER160_TAXPAID></UNDER160_TAXPAID>
		<UNDER160_USA></UNDER160_USA>
		<UNDER160_EXPORT></UNDER160_EXPORT>
		<UNDER160_TRANS_FTZ></UNDER160_TRANS_FTZ>
		<UNDER160_TRANS_CMBW></UNDER160_TRANS_CMBW>
		<UNDER160_SUPPLIES></UNDER160_SUPPLIES>
		<UNDER160_TRANS_CBW></UNDER160_TRANS_CBW>
		<UNDER160_RESEARCH></UNDER160_RESEARCH>
		<UNDER160_TRANS_PROC></UNDER160_TRANS_PROC>
		<UNDER160_TRANS_PROD></UNDER160_TRANS_PROD>
		<UNDER160_TRANS_OTHER></UNDER160_TRANS_OTHER>
		<UNDER160_DESTROY></UNDER160_DESTROY>
		<UNDER160_21></UNDER160_21>
		<UNDER160_LOSS></UNDER160_LOSS>
		<UNDER160_ONHAND_EOM></UNDER160_ONHAND_EOM>
		<UNDER160_TOTAL2></UNDER160_TOTAL2>
		<OVER160_ONHAND></OVER160_ONHAND>
		<OVER160_DEP_BULK></OVER160_DEP_BULK>
		<OVER160_RECEIVED></OVER160_RECEIVED>
		<OVER160_RET_BULK></OVER160_RET_BULK>
		<OVER160_5></OVER160_5>
		<OVER160_TOTAL1></OVER160_TOTAL1>
		<OVER160_TAXPAID></OVER160_TAXPAID>
		<OVER160_USA></OVER160_USA>
		<OVER160_EXPORT></OVER160_EXPORT>
		<OVER160_TRANS_FTZ></OVER160_TRANS_FTZ>
		<OVER160_TRANS_CMBW></OVER160_TRANS_CMBW>
		<OVER160_SUPPLIES></OVER160_SUPPLIES>
		<OVER160_TRANS_CBW></OVER160_TRANS_CBW>
		<OVER160_RESEARCH></OVER160_RESEARCH>
		<OVER160_TRANS_PROC></OVER160_TRANS_PROC>
		<OVER160_TRANS_PROD></OVER160_TRANS_PROD>
		<OVER160_TRANS_OTHER></OVER160_TRANS_OTHER>
		<OVER160_DESTROY></OVER160_DESTROY>
		<OVER160_21></OVER160_21>
		<OVER160_LOSS></OVER160_LOSS>
		<OVER160_ONHAND_EOM></OVER160_ONHAND_EOM>
		<OVER160_TOTAL2></OVER160_TOTAL2>
		<UNDER170_ONHAND></UNDER170_ONHAND>
		<UNDER170_DEP_BULK></UNDER170_DEP_BULK>
		<UNDER170_RECEIVED></UNDER170_RECEIVED>
		<UNDER170_RET_BULK>12.00</UNDER170_RET_BULK>
		<UNDER170_5></UNDER170_5>
		<UNDER170_TOTAL1></UNDER170_TOTAL1>
		<UNDER170_TAXPAID></UNDER170_TAXPAID>
		<UNDER170_USA></UNDER170_USA>
		<UNDER170_EXPORT></UNDER170_EXPORT>
		<UNDER170_TRANS_FTZ></UNDER170_TRANS_FTZ>
		<UNDER170_TRANS_CMBW></UNDER170_TRANS_CMBW>
		<UNDER170_SUPPLIES></UNDER170_SUPPLIES>
		<UNDER170_TRANS_WINE></UNDER170_TRANS_WINE>
		<UNDER170_TRANS_CBW></UNDER170_TRANS_CBW>
		<UNDER170_RESEARCH></UNDER170_RESEARCH>
		<UNDER170_TRANS_PROC></UNDER170_TRANS_PROC>
		<UNDER170_TRANS_PROD></UNDER170_TRANS_PROD>
		<UNDER170_TRANS_OTHER></UNDER170_TRANS_OTHER>
		<UNDER170_DESTROY></UNDER170_DESTROY>
		<UNDER170_21></UNDER170_21>
		<UNDER170_LOSS></UNDER170_LOSS>
		<UNDER170_ONHAND_EOM></UNDER170_ONHAND_EOM>
		<UNDER170_TOTAL2></UNDER170_TOTAL2>
		<OVER170_ONHAND></OVER170_ONHAND>
		<OVER170_DEP_BULK></OVER170_DEP_BULK>
		<OVER170_RECEIVED></OVER170_RECEIVED>
		<OVER170_RET_BULK>12.00</OVER170_RET_BULK>
		<OVER170_5></OVER170_5>
		<OVER170_TOTAL1></OVER170_TOTAL1>
		<OVER170_TAXPAID></OVER170_TAXPAID>
		<OVER170_USA></OVER170_USA>
		<OVER170_EXPORT></OVER170_EXPORT>
		<OVER170_TRANS_FTZ></OVER170_TRANS_FTZ>
		<OVER170_TRANS_CMBW></OVER170_TRANS_CMBW>
		<OVER170_SUPPLIES></OVER170_SUPPLIES>
		<OVER170_TRANS_WINE></OVER170_TRANS_WINE>
		<OVER170_TRANS_CBW></OVER170_TRANS_CBW>
		<OVER170_RESEARCH></OVER170_RESEARCH>
		<OVER170_TRANS_PROC></OVER170_TRANS_PROC>
		<OVER170_TRANS_PROD></OVER170_TRANS_PROD>
		<OVER170_TRANS_OTHER></OVER170_TRANS_OTHER>
		<OVER170_DESTROY></OVER170_DESTROY>
		<OVER170_21></OVER170_21>
		<OVER170_LOSS></OVER170_LOSS>
		<OVER170_ONHAND_EOM></OVER170_ONHAND_EOM>
		<OVER170_TOTAL2></OVER170_TOTAL2>
		<RUM_ONHAND></RUM_ONHAND>
		<RUM_DEP_BULK></RUM_DEP_BULK>
		<RUM_RECEIVED></RUM_RECEIVED>
		<RUM_RET_BULK></RUM_RET_BULK>
		<RUM_5></RUM_5>
		<RUM_TOTAL1></RUM_TOTAL1>
		<RUM_TAXPAID></RUM_TAXPAID>
		<RUM_USA></RUM_USA>
		<RUM_EXPORT></RUM_EXPORT>
		<RUM_TRANS_FTZ></RUM_TRANS_FTZ>
		<RUM_TRANS_CMBW></RUM_TRANS_CMBW>
		<RUM_SUPPLIES></RUM_SUPPLIES>
		<RUM_TRANS_CBW></RUM_TRANS_CBW>
		<RUM_RESEARCH></RUM_RESEARCH>
		<RUM_TRANS_PROC></RUM_TRANS_PROC>
		<RUM_TRANS_PROD></RUM_TRANS_PROD>
		<RUM_TRANS_OTHER></RUM_TRANS_OTHER>
		<RUM_DESTROY></RUM_DESTROY>
		<RUM_21></RUM_21>
		<RUM_LOSS></RUM_LOSS>
		<RUM_ONHAND_EOM></RUM_ONHAND_EOM>
		<RUM_TOTAL2></RUM_TOTAL2>
		<GIN_ONHAND></GIN_ONHAND>
		<GIN_DEP_BULK></GIN_DEP_BULK>
		<GIN_RECEIVED></GIN_RECEIVED>
		<GIN_RET_BULK></GIN_RET_BULK>
		<GIN_5></GIN_5>
		<GIN_TOTAL1></GIN_TOTAL1>
		<GIN_TAXPAID></GIN_TAXPAID>
		<GIN_USA></GIN_USA>
		<GIN_EXPORT></GIN_EXPORT>
		<GIN_TRANS_FTZ></GIN_TRANS_FTZ>
		<GIN_TRANS_CMBW></GIN_TRANS_CMBW>
		<GIN_SUPPLIES></GIN_SUPPLIES>
		<GIN_TRANS_CBW></GIN_TRANS_CBW>
		<GIN_RESEARCH></GIN_RESEARCH>
		<GIN_TRANS_PROC></GIN_TRANS_PROC>
		<GIN_TRANS_PROD></GIN_TRANS_PROD>
		<GIN_TRANS_OTHER></GIN_TRANS_OTHER>
		<GIN_DESTROY></GIN_DESTROY>
		<GIN_21></GIN_21>
		<GIN_LOSS></GIN_LOSS>
		<GIN_ONHAND_EOM></GIN_ONHAND_EOM>
		<GIN_TOTAL2></GIN_TOTAL2>
		<VODKA_ONHAND></VODKA_ONHAND>
		<VODKA_DEP_BULK></VODKA_DEP_BULK>
		<VODKA_RECEIVED></VODKA_RECEIVED>
		<VODKA_RET_BULK></VODKA_RET_BULK>
		<VODKA_5></VODKA_5>
		<VODKA_TOTAL1></VODKA_TOTAL1>
		<VODKA_TAXPAID></VODKA_TAXPAID>
		<VODKA_USA></VODKA_USA>
		<VODKA_EXPORT></VODKA_EXPORT>
		<VODKA_TRANS_FTZ></VODKA_TRANS_FTZ>
		<VODKA_TRANS_CMBW></VODKA_TRANS_CMBW>
		<VODKA_SUPPLIES></VODKA_SUPPLIES>
		<VODKA_TRANS_CBW></VODKA_TRANS_CBW>
		<VODKA_RESEARCH></VODKA_RESEARCH>
		<VODKA_TRANS_PROC></VODKA_TRANS_PROC>
		<VODKA_TRANS_PROD></VODKA_TRANS_PROD>
		<VODKA_TRANS_OTHER></VODKA_TRANS_OTHER>
		<VODKA_DESTROY></VODKA_DESTROY>
		<VODKA_21></VODKA_21>
		<VODKA_LOSS></VODKA_LOSS>
		<VODKA_ONHAND_EOM></VODKA_ONHAND_EOM>
		<VODKA_TOTAL2></VODKA_TOTAL2>
		<OVER190_ONHAND></OVER190_ONHAND>
		<OVER190_DEP_BULK></OVER190_DEP_BULK>
		<OVER190_RECEIVED></OVER190_RECEIVED>
		<OVER190_RET_BULK>13.00</OVER190_RET_BULK>
		<OVER190_5></OVER190_5>
		<OVER190_TOTAL1>16.00</OVER190_TOTAL1>
		<OVER190_TAXPAID></OVER190_TAXPAID>
		<OVER190_USA></OVER190_USA>
		<OVER190_EDUC></OVER190_EDUC>
		<OVER190_EXPORT></OVER190_EXPORT>
		<OVER190_TRANS_FTZ></OVER190_TRANS_FTZ>
		<OVER190_TRANS_CMBW></OVER190_TRANS_CMBW>
		<OVER190_SUPPLIES></OVER190_SUPPLIES>
		<OVER190_TRANS_WINE></OVER190_TRANS_WINE>
		<OVER190_TRANS_CBW></OVER190_TRANS_CBW>
		<OVER190_RESEARCH></OVER190_RESEARCH>
		<OVER190_TRANS_PROC></OVER190_TRANS_PROC>
		<OVER190_TRANS_PROD></OVER190_TRANS_PROD>
		<OVER190_TRANS_OTHER></OVER190_TRANS_OTHER>
		<OVER190_DESTROY></OVER190_DESTROY>
		<OVER190_21></OVER190_21>
		<OVER190_LOSS></OVER190_LOSS>
		<OVER190_ONHAND_EOM></OVER190_ONHAND_EOM>
		<OVER190_TOTAL2>16.00</OVER190_TOTAL2>
		<UNDER190_ONHAND></UNDER190_ONHAND>
		<UNDER190_DEP_BULK></UNDER190_DEP_BULK>
		<UNDER190_RECEIVED></UNDER190_RECEIVED>
		<UNDER190_RET_BULK>12.00</UNDER190_RET_BULK>
		<UNDER190_5></UNDER190_5>
		<UNDER190_TOTAL1></UNDER190_TOTAL1>
		<UNDER190_TAXPAID></UNDER190_TAXPAID>
		<UNDER190_USA></UNDER190_USA>
		<UNDER190_EXPORT></UNDER190_EXPORT>
		<UNDER190_TRANS_FTZ></UNDER190_TRANS_FTZ>
		<UNDER190_TRANS_CMBW></UNDER190_TRANS_CMBW>
		<UNDER190_SUPPLIES></UNDER190_SUPPLIES>
		<UNDER190_TRANS_WINE></UNDER190_TRANS_WINE>
		<UNDER190_TRANS_CBW></UNDER190_TRANS_CBW>
		<UNDER190_RESEARCH></UNDER190_RESEARCH>
		<UNDER190_TRANS_PROC></UNDER190_TRANS_PROC>
		<UNDER190_TRANS_PROD></UNDER190_TRANS_PROD>
		<UNDER190_TRANS_OTHER></UNDER190_TRANS_OTHER>
		<UNDER190_DESTROY></UNDER190_DESTROY>
		<UNDER190_21></UNDER190_21>
		<UNDER190_LOSS></UNDER190_LOSS>
		<UNDER190_ONHAND_EOM></UNDER190_ONHAND_EOM>
		<UNDER190_TOTAL2></UNDER190_TOTAL2>
		<OTHER_ONHAND></OTHER_ONHAND>
		<OTHER_DEP_BULK></OTHER_DEP_BULK>
		<OTHER_RECEIVED></OTHER_RECEIVED>
		<OTHER_RET_BULK></OTHER_RET_BULK>
		<OTHER_5></OTHER_5>
		<OTHER_TOTAL1></OTHER_TOTAL1>
		<OTHER_TAXPAID></OTHER_TAXPAID>
		<OTHER_USA></OTHER_USA>
		<OTHER_EXPORT></OTHER_EXPORT>
		<OTHER_TRANS_FTZ></OTHER_TRANS_FTZ>
		<OTHER_TRANS_CMBW></OTHER_TRANS_CMBW>
		<OTHER_SUPPLIES></OTHER_SUPPLIES>
		<OTHER_TRANS_CBW></OTHER_TRANS_CBW>
		<OTHER_RESEARCH></OTHER_RESEARCH>
		<OTHER_TRANS_PROC></OTHER_TRANS_PROC>
		<OTHER_TRANS_PROD></OTHER_TRANS_PROD>
		<OTHER_TRANS_OTHER></OTHER_TRANS_OTHER>
		<OTHER_DESTROY></OTHER_DESTROY>
		<OTHER_21></OTHER_21>
		<OTHER_LOSS></OTHER_LOSS>
		<OTHER_ONHAND_EOM></OTHER_ONHAND_EOM>
		<OTHER_TOTAL2></OTHER_TOTAL2>
		<WINE_ONHAND></WINE_ONHAND>
		<WINE_DEP_BULK></WINE_DEP_BULK>
		<WINE_5></WINE_5>
		<WINE_TOTAL1></WINE_TOTAL1>
		<WINE_TRANS_PROC></WINE_TRANS_PROC>
		<WINE_TRANS_PROD></WINE_TRANS_PROD>
		<WINE_TRANS_OTHER></WINE_TRANS_OTHER>
		<WINE_DESTROY></WINE_DESTROY>
		<WINE_21></WINE_21>
		<WINE_LOSS></WINE_LOSS>
		<WINE_ONHAND_EOM></WINE_ONHAND_EOM>
		<PROPRIETOR2></PROPRIETOR2>
		<PAGENO_></PAGENO_>
		<RETURN_TYPE></RETURN_TYPE>
		<OTHER> </OTHER>
		<TOTAL_ONHAND></TOTAL_ONHAND>
		<TOTAL_RECEIVED></TOTAL_RECEIVED>
		<TOTAL_RET_BULK></TOTAL_RET_BULK>
		<TOTAL_5></TOTAL_5>
		<TOTAL_TOTAL1></TOTAL_TOTAL1>
		<TOTAL_TRANS_OTHER></TOTAL_TRANS_OTHER>
		<TOTAL_DESTROY></TOTAL_DESTROY>
		<TOTAL_21></TOTAL_21>
		<TOTAL_LOSS></TOTAL_LOSS>
		<TOTAL_ONHAND_EOM></TOTAL_ONHAND_EOM>
		<WINE_TOTAL2></WINE_TOTAL2>
		<TOTAL_TOTAL2></TOTAL_TOTAL2>
		<Perjury>1</Perjury>
		<DATE></DATE>
		<SIGNATURE></SIGNATURE>
		<TITLE></TITLE>
		<NAME_FIRST></NAME_FIRST>
		<NAME_MIDDLE></NAME_MIDDLE>
		<NAME_LAST></NAME_LAST>
		<NAME_SUFFIX></NAME_SUFFIX>
		<USER_ID></USER_ID>
		<USERID></USERID>
		<REPORTING_MONTH></REPORTING_MONTH>
		<PERIOD_YEAR></PERIOD_YEAR>
	</page1>
	<page2>
		<MESSAGES>&#13;
&#13;
For values in Lines 8 - 16, please make sure to maintain records that establish proof that spirits shown were withdrawn as authorized by regulations.&#13;
&#13;
Line 2 - If this amount came from your production account, you must file TTB Form 5110.40, or if received in bond, you must have an approved TTB Form 5100.16 on file.&#13;
&#13;
Line 7 - If an amount is entered on this line - Excise tax returns for the month covered by this report should include tax liability on any quantities shown here.&#13;
&#13;
Line 8 - An amount is entered on this line - only if Tax Free Alcohol is shipped solely to U.S. Governmental Agencies holding a Permit on TTB F 5150.33.&#13;
&#13;
Lines 10-13 and 15 - If amounts are entered into any of these lines - The monthly total should have been shown on TTB Form(s) 5100.11.&#13;
&#13;
Line 17 - If amount is entered on this line - TTB Report 5110.28 must be filed.&#13;
&#13;
Line 18 - If an amount is entered on this line - TTB Report 5110.40 must be filed.&#13;
&#13;
Do you want to continue?</MESSAGES>
		<DOMESTIC>-1</DOMESTIC>
		<PUERTO_RICAN>0</PUERTO_RICAN>
		<IMPORTED>0</IMPORTED>
		<VIRGIN_ISLANDS>0</VIRGIN_ISLANDS>
		<RETURN_AMEND>0</RETURN_AMEND>
		<RETURN_ORIGINAL>-1</RETURN_ORIGINAL>
	</page2>
	<RETURNTYPE>Original</RETURNTYPE>
	<REPORT_COVERS>1</REPORT_COVERS>
	<TOTAL_DEP_BULK></TOTAL_DEP_BULK>
	<TOTAL_TAXPAID></TOTAL_TAXPAID>
	<TOTAL_USA></TOTAL_USA>
	<TOTAL_EDUC></TOTAL_EDUC>
	<TOTAL_EXPORT></TOTAL_EXPORT>
	<TOTAL_TRANS_FTZ></TOTAL_TRANS_FTZ>
	<TOTAL_TRANS_CMBW></TOTAL_TRANS_CMBW>
	<TOTAL_SUPPLIES></TOTAL_SUPPLIES>
	<TOTAL_TRANS_WINE></TOTAL_TRANS_WINE>
	<TOTAL_TRANS_CBW></TOTAL_TRANS_CBW>
	<TOTAL_RESEARCH></TOTAL_RESEARCH>
	<TOTAL_TRANS_PROC></TOTAL_TRANS_PROC>
	<TOTAL_TRANS_PROD></TOTAL_TRANS_PROD>
</uploaddata>
