FOR TTB USE ONLY	DEPARTMENT OF THE TREASURY ALCOHOL AND TOBACCO TAX AND TRADE BUREAU APPLICATION FOR AND CERTIFICATION/EXEMPTION OF LABEL/BOTTLE APPROVAL (See Instructions and Paperwork Reduction Act Notice on Back)
TTB ID 06072001000158
1. REP. ID. NO. (If any) CT 662 OR 81

PART I - APPLICATION
2. PLANT REGISTRY/BASIC PERMIT/BREWER'S NO. (Required) CA-I-15222	7. NAME AND ADDRESS OF APPLICANT AS SHOWN ON PLANT REGISTRY, BASIC PERMIT OR BREWER'S NOTICE. INCLUDE APPROVED DBA OR TRADENAME IF USED ON LABEL (Required) imports without borders, IMPORTS WITHOUT BORDERS 524 PATRICIA LN PALO ALTO CA 94303
3. SERIAL NUMBER (Required) 06MK01 4. TYPE OF PRODUCT (Required) WINE DISTILLED SPIRITS MALT BEVERAGE
5. BRAND NAME (Required) MOKKA	7a. MAILING ADDRESS, IF DIFFERENT
6. FANCIFUL NAME (If any) LICOR DE CAFE (COFFEE LIQUEUR)

8. EMAIL ADDRESS	9. FORMULA/SOP NO. (If any)	10. LAB. NO./DATE (If any) 06031002000124 - 02/06/2006	17. TYPE OF APPLICATION (Check applicable box(es)) a. CERTIFICATE OF LABEL APPROVAL b. CERTIFICATE OF EXEMPTION FROM LABEL APPROVAL "For sale in _______ only" (Fill in State abbreviation.) c. DISTINCTIVE LIQUOR BOTTLE APPROVAL. TOTAL BOTTLE CAPACITY BEFORE CLOSURE ____ _____ (Fill in amount) d. RESUBMISSION AFTER REJECTION TTB ID. NO. ______
11. NET CONTENTS 1 LITER	12. ALCOHOL CONTENT 26.5	13. WINE APPELLATION IF ON LABEL
14. WINE VINTAGE DATE IF ON LABEL	15. PHONE NUMBER (650) 269-0962	16. FAX NUMBER (650) 327-4515
18. SHOW ANY WORDING (a) APPEARING ON MATERIALS FIRMLY AFFIXED TO THE CONTAINER (e.g., caps, celoseals, corks, etc.) OTHER THAN THE LABLES AFFIXED BELOW, OR (b) BLOWN, BRANDED OR EMBOSSED ON THE CONTAINER (e.g., net contents etc.). THIS WORDING MUST BE NOTED HERE EVEN IF IT DUPLICATES PORTIONS OF THE LABELS AFFIXED BELOW. ALSO, PROVIDE TRANSLATIONS OF FOREIGN LANGUAGE TEXT APPEARING ON LABELS.

PART II - APPLICANT'S CERTIFICATION
Under the penalties of perjury, I declare; that all statements appearing on this application are true and correct to the best of my knowledge and belief; and, that the representations on the labels attached to this form, including supplemental documents, truly and correctly represent the content of the containers to which these labels will be applied. I also certify that I have read, understood and complied with the conditions and instructions which are attached to an original TTB F 5100.31, Certificate/Exemption of Label/Bottle Approval.
19. DATE OF APPLICATION 03/13/2006	20. SIGNATURE OF APPLICANT OR AUTHORIZED AGENT (Application was e-filed)	21. PRINT NAME OF APPLICANT OR AUTHORIZED AGENT VICTOR ZILINSKAS

PART III - TTB CERTIFICATE
This certificate is issued subject to applicable laws, regulations and conditions as set forth in the instructions portion of this form.
22. DATE ISSUED 03/24/2006	23. AUTHORIZED SIGNATURE, ALCOHOL AND TOBACCO TAX AND TRADE BUREAU

FOR TTB USE ONLY
QUALIFICATIONS STATUS THE STATUS IS APPROVED. CLASS/TYPE DESCRIPTION COFFEE (CAFE) LIQUEUR	EXPIRATION DATE (If any)

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AFFIX COMPLETE SET OF LABELS BELOW

Image Type:

Brand (front) or keg collar
Actual Dimensions: 4.13 inches W X 5.25 inches H

Image Type:

Back
Actual Dimensions: 4.13 inches W X 4.52 inches H

Image Type:

Neck
Actual Dimensions: 2.38 inches W X 1.70 inches H

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