OMB No. 1513-0020
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
23061001000043
1. REP. ID. NO. (If any)
CT
101
OR
22
PART I - APPLICATION
2. PLANT REGISTRY/BASIC PERMIT/BREWER'S NO. (Required)
DSP-KY-20075
3. SOURCE OF PRODUCT (Required)
Domestic
Imported
8. 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)

BLUEGRASS BOTTLING, Bluegrass Bottling LLC
1065 HIGHWAY 78

Stanford KY 40484
4. SERIAL NUMBER (Required)
23FWSB
5. TYPE OF PRODUCT (Required)
WINE
DISTILLED SPIRITS
MALT BEVERAGE

6. BRAND NAME (Required)
FREEDOM WHISKEY CO.
8a. MAILING ADDRESS, IF DIFFERENT
7. FANCIFUL NAME (If any)
SMALL BATCH
9. FORMULA
10. GRAPE VARIETAL(S) (Wine Only)
N/A
14. 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. WINE APPELLATION (If on label)
12. PHONE NUMBER
(859) 329-8877
13. EMAIL ADDRESS
 
15. SHOW ANY INFORMATION THAT IS BLOWN, BRANDED, OR EMBOSSED ON THE CONTAINER (e.g., net contents) ONLY IF IT DOES NOT APPEAR ON THE LABELS AFFIXED BELOW. ALSO, SHOW 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.
16. DATE OF APPLICATION
03/02/2023
17. SIGNATURE OF APPLICANT OR AUTHORIZED AGENT
(Application was e-filed)
18. PRINT NAME OF APPLICANT OR AUTHORIZED AGENT
lisa strevels
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.
19. DATE ISSUED
03/15/2023
20. AUTHORIZED SIGNATURE, ALCOHOL AND TOBACCO TAX AND TRADE BUREAU
Authorized Signature

FOR TTB USE ONLY
QUALIFICATIONS
When new labels are printed the name and address statement of the responsible bottler must reflect the address on the basic permit or brewer's notice
This certificate is operative for the release of not more than the following number of bottle cases/ kegs. (4,170 labels)
This use-up authorizes the depletion of product and labels that are currently in existence as of the date the use-up was requested. No additional product may be made and no additional labels may be printed.
Please note that this approval is for the single label attached to this COLA. No other labels may appear on the container.
TTB has not reviewed this label for type size, characters per inch or contrasting background. The responsible industry member must continue to ensure that the mandatory information on the actual labels is displayed in the correct type size, number of characters per inch, and on a contrasting background in accordance with the TTB labeling regulations, 27 CFR parts 4, 5, 7, and 16, as applicable.

STATUS
THE STATUS IS EXPIRED.

CLASS/TYPE DESCRIPTION
STRAIGHT BOURBON WHISKY
EXPIRATION DATE (If any)
06/14/2023

AFFIX COMPLETE SET OF LABELS BELOW

Image Type:

Brand (front) or keg collar
Actual Dimensions: 8 inches W X 5 inches H


Note: The image below has been reduced to fit the page. See actual dimensions above.
Label Image: Brand (front) or keg collar



TTB F 5100.31 (06-2016)    PREVIOUS EDITIONS ARE OBSOLETE