Label Product Application {BWL-008}

Amount Fee Paid: _______________ Date: _________________________ Received by: __________________ Check #: ______________________ North Carolina Alcoholic Beverage Control Commission 4307 Mail Service Center Raleigh, NC 27699-4307 (919) 779-0700 Approved. . . . . . . . . . . . . . . . . . Disapproved. . . . . . . . . . . . . . . . Date: ______________________ N.C. Product Code #: Label/Product Application Above for office use only. Company Name: __________________________________________________N.C. Permit # ____________________ Mailing Address: __________________________________________________________________________________ Contact Person: __________________________________________Email Address: ____________________________ Phone #: __________________________________________ Fax #: _________________________________________ New Product Label Revision ­ Product Code # _______________ Transfer of Brand Brand Name: ________________________________________Fanciful Name: _________________________________ Varietal/Type: ______________________________________________ Sizes: __________________________________ Primary Source? ___ No ___Yes (Attach letter) PRODUCT ANALYSIS CERTIFICATION I, ______________________________________________________, hereby verify that the above product is analyzed to be ____________ % alcohol by volume. Signature: ____________________________________________Title: _______________________________________ All labels that will appear on the container must be affixed below. Use back if necessary. This form must be stapled to the Federal Certificate of Label Approval (COLA). BWL-008 Rev. 9/5/2006 American LegalNet, Inc. www.FormsWorkflow.com Label/Product Application Instructions Please print or type all information on this application with the exception of the signature requested for the wine analysis statement. North Carolina's basic label requirements are as follows: MALT BEVERAGE ­ brand name of product, name and address of brewer, bottler or importer, class/type of product (ale, lager, porter, etc.), net contents and Government Health Warning statement. WINE ­ brand name of product, class/type (varietal name), name and address of manufacturer, bottler or importer, net contents, Government Health Warning statement. A number will be assigned to each product being submitted whether approval or disapproval is granted. The suffix of the code number determines how the product is classified by the state. B ­ malt beverage U ­ unfortified wine F ­ fortified i NEW LABEL REGISTRATION: 1. ONE PRODUCT PER FORM ­ Use a separate Label/Product Application For (BWL-008) for each product being submitted. If you will be shipping more than one size, include all sizes for each product on one form. Staple the NC Label/Product Approval form to the corresponding federal COLA when submitting. LABELS ­ Attach a complete set of original labels to the bottom front or back of the form. Include all labels that will appear on the bottle or container for each size being shipped. Complete the Product Analysis Certification section of this form; submit a certified laboratory analysis or submit a sample bottle if no analysis or certification has been completed. (Submitting a sample bottle for our analysis may delay the label/product approval for up to 6 weeks.) FEES ­ Submit $10.00 for each product for which you have provided a Product Analysis Certification either on this form or on a separate sheet of paper. If submitting a sample bottle without the Product Analysis Certification, the fee is $25.00. The fees for label approvals may be combined in one check. (Example: If you have 10 products you are submitting with analysis statements, send us a check for $100.00.) COLA ­ Submit a copy of the Federal Certificate of Label Approval (COLA) for all sizes being shipped. If your company is a North Carolina brewpub, you must obtain from TTB an exemption of label approval or a Certificate of Label Approval. Please contact TTB for instructions. AUTHORIZATION LETTER ­ If the Federal COLA is not in the supplier's name, you must submit an authorization letter allowing you to use their federal COLA for registration purposes. PRIMARY SOURCE ­ Submit a copy of the Primary Source letter. NC BREWPUBS ­ ALL PRODUCTS MUST BE APPROVED REGARDLESS OF THE CONTAINER AND LABEL. Label approval requirements depend on how the products are stored/packaged. Stationary Tanks ­ If the products are piped from stationary tanks, the tank must contain a Government Health Warning statement. Product approval is required. No labels need to be submitted for stationary tanks. Kegs ­ If the products are piped from movable kegs, the kegs must contain all required label information including the Government Health Warning statement. Kegs require both product and label approval by the state and TTB. Growlers that are filled on request do not require label approval. However, if the growlers are pre-filled they require both state and federal label approval. Product approval is always required. 9. APPROVAL/DISAPPROVAL LETTER ­ Please keep a copy of all items being submitted for approval. You will not receive a copy back in the mail. You will be notified by letter of the approval/disapproval. Each item being submitted is assigned a NC Product Code Number. Please refer to this number when contacting this office with questions or correspondence, or when filing a label revision. 2. 3. 4. 5. 6. 7. 8. 10. DISTRIBUTION AGREEMENT FILING FORM ­ If you are submitting a new brand and not a brand extension, you must complete a Distribution Filing form (ART12-13). (Continued on next page.) BWL-008 Rev. 08/06 American LegalNet, Inc. www.FormsWorkflow.com REVISED LABEL REGISTRATION: For products that have previously been registered and have undergone a change in the label that requires the company to file for a new Federal Certificate of Label Approval a state label revision is necessary: 1. 2. 3. 4. 5. COLA - Submit a copy of the Federal Certificate of Label Approval (COLA) with one set of original labels attached to the back of the form. NC CODE NUMBER - Note the North Carolina Product Code Number in the upper right hand corner on the front side of the COLA. NO ANALYSIS - An analysis statement is not required for label revisions. APPROVAL/DISAPPROVAL LETTER - Please keep a copy for your files. You will not receive a copy back, but you will be notified of the approval/disapproval by letter. NO FEE - There is no fee for label revisions. 6. VINTAGE CHA