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
23195001000574

1. REP. ID. NO. (If any)
CT
101

OR
35

PART I - APPLICATION
2. PLANT REGISTRY/BASIC PERMIT/BREWER'S NO. (Required)
DSP-NC-21147
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)

BHAWK, Brad Halling American Whiskey Co. LLC
175 YADKIN RD

Southern Pines NC 28387

BRAD HALLING AMERICAN WHISKEY KO. (Used on label)
4. SERIAL NUMBER (Required)
230001

5. TYPE OF PRODUCT (Required)
WINE
DISTILLED SPIRITS
MALT BEVERAGE

6. BRAND NAME (Required)
MADAM COLONEL
8a. MAILING ADDRESS, IF DIFFERENT
7. FANCIFUL NAME (If any)
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
(910) 986-6885
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.
MADAM TRD COLONEL MRK MADAM COLONEL REPRESENTS A JOURNEY IN PERSEVERING AND BELIEVING IN ONESELF. IT¿S ALSO ABOUT EXPRESSING GRATITUDE FOR OPPORTUNITY, CELEBRATING VICTORIES, AND RAISING A GLASS TO THE MENTORS AND LEADERS IN OUR LIVES. IN 1991, I JOINED THE US ARMY AT AGE 17 TO SERVE OUR GREAT NATION. AFTER 29 YEARS OF SERVICE, I REFLECT UPON THIS CHALLENGING YET REWARDING JOURNEY FROM PRIVATE TO COLONEL. THE OPPORTUNITY TO SERVE ALONGSIDE OUR NATION¿S MOST REMARKABLE SOLDIERS, NON-COMMISSIONED OFFICERS, AND OFFICERS MADE SERVICE THE ABSOLUTE PRIVILEGE OF A LIFETIME. ________JESSICA A. HALLING________ JESSICA A. HALLING COLONEL, U.S. ARMY, RETIRED MADAM COLONEL IS A FAMILY OF PREMIUM SPIRITS DEDICATED TO HONORING THOSE WITH THE WILL TO ACHIEVE. WE¿D BE HONORED TO RAISE THE AMERICAN SPIRIT WITH YOU. PLEASE JOIN US AT OUR DISTILLERY IN SOUTHERN PINES, NORTH CAROLINA. HALLINGWHISKEY.COM
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
07/14/2023
17. SIGNATURE OF APPLICANT OR AUTHORIZED AGENT
(Application was e-filed)
18. PRINT NAME OF APPLICANT OR AUTHORIZED AGENT
Jessica Halling
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
07/17/2023
20. AUTHORIZED SIGNATURE, ALCOHOL AND TOBACCO TAX AND TRADE BUREAU
Authorized Signature

FOR TTB USE ONLY
QUALIFICATIONS
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 APPROVED.

CLASS/TYPE DESCRIPTION
STRAIGHT BOURBON WHISKY

EXPIRATION DATE (If any)

AFFIX COMPLETE SET OF LABELS BELOW

Image Type:

Brand (front) or keg collar
Actual Dimensions: 9.52 inches W X 11.57 inches H


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


Image Type:

Neck
Actual Dimensions: 3.44 inches W X 0.57 inches H


Label Image: Neck


Image Type:

Other
Actual Dimensions: 8.03 inches W X 0.98 inches H


Note: The image below has been reduced to fit the page. See actual dimensions above.
Label Image: Other




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