CPLBD INST REV 7/18 STATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION Website: www.ct.gov/dcp Email: dcp.brands@ct.gov Instructions for Liquor Brand Label Registration Application Form Required Documentation Checklist Attach the federal label approval for each brand requesting registration. Attach one label for each brand (product) requesting registration. If the label is painted and/or silk screened on the bottle, please provide a color photograph of each label. Attach an independent laboratory analysis or notarized statement detailing the alcohol type and proof for each beer, wine and/or liquor product. Attach authorization from the manufacturer, if the registrant is not the manufacturer of the product. When alcoholic beverages are imported into the United States, the labels should bear the registrant222s name as to the importer. A d/b/a may be used; however, documentation must be submitted indicating a business name is to be used by the registrant. Label Requirements UNIMERC brand code numbers are no longer a requirement to obtain a liquor brand registration from thisDepartment.In order for a label to be considered a private label, the registrant must furnish the department with thename and address of the retailer who will sell such brand. Any labels submitted for registration withoutsuch accompanying information shall be considered to be for general distribution.In regard to wines, different vintages do not have to be registered, only different brands (varietels). When changing the proof of a product, you must re-register the brand.Decanter registrations; all of the requirements apply, except for the fee. If the contents have beenpreviously approved, the fee is exempt; however a photograph of the decanter must accompany the brandregistration application.Connecticut General Statutes requires that containers of beer or other malt beverages sold in Connecticutbe labeled with deposit and refund information as an environmental control. While this agency does notreview labels for this information, it is your responsibility to ensure that your labeling meets theserequirements. For more information, contact the Department of Energy & Environmental Protection atwww.ct.gov/deep. This application is only to be used to register a liquor brand label not already registered in CT. Allproducts registered in CT may be verified online at www.elicense.gov. You must hold an active Connecticut Out of State Shipper Liquor Permit or Manufacturer Liquor Permitto register a liquor brand. The company name, address, Connecticut liquor permit number and email address must be indicated onthe application form. The email address provided will be for all correspondence, the approval of the label,application deficiencies, etc.The brand label registration application form must be completed with the full individual product brandlabel name, distributor(s) and territories (if applicable).The fee (for a 3-year period) for a registrant located in Connecticut or located Out-of-State is $200.00 per label. The fee for products manufactured in the state of Connecticut by a Connecticut Manufacturer is$15.00 per label. Payments must in the form of a check or money order made payable to 223Treasurer, State of Connecticut.224 All fees are non-refundable and non-transferable.The completed application, all applicable documentation and fee is to be mailed to the address listed onthe application. Incomplete applications will result in the delay in processing of your registration.Questions should be emailed to dcp.brands@ct.gov. American LegalNet, Inc. www.FormsWorkFlow.com CPLBD Rev 7/18 STATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION LICENSE SERVICES DIVISION 450 COLUMBUS BLVD, STE. 801 HARTFORD, CT 06103 Email: dcp.brands@ct.gov Website: www.ct.gov/dcp Liquor Brand Label Registration Application Name of Company Street Address City State Zip Code CT Liquor Permit Number Email Address (for all correspondence, approval of label, application deficiencies, etc.) Individual Product Brand Name (as it appears on the label) DBA/Trade Name YES NO List the wholesaler(s) for this brand or indicate direct to consumer 1. List the geographic area(s) assigned to each wholesaler 2. 3. 4. Individual Product Brand Name (as it appears on the label) DBA/Trade Name YES NO List the wholesaler(s) for this brand or indicate direct to consumer 1. List the geographic area(s) assigned to each wholesaler 2. 3. 4. Individual Product Brand Name (as it appears on the label) DBA/Trade Name YES NO List the wholesaler(s) for this brand or indicate direct to consumer 1. List the geographic area(s) assigned to each wholesaler 2. 3. 4. Individual Product Brand Name (as it appears on the label) DBA/Trade Name YES NO List the wholesaler(s) for this brand or indicate direct to consumer 1. List the geographic area(s) assigned to each wholesaler 2. 3. 4. For Official Use Only The company name, CT liquor permit number, email address, wholesaler and geographic areas assigned must be listed on the application form(s). The completed application, all applicable documentation and fee is to be mailed to the address above. Please refer to the instruction page for additional information and instruction. Fee per label (for a 3-year period). Check or money order must be made payable to 223Treasurer, State of Connecticut.224 All feesare non-refundable and non-transferable:Registrant located in Connecticut OR Out-of-State $200.00 Manufacturer located in Connecticut $ 15.00 American LegalNet, Inc. www.FormsWorkFlow.com Individual Product Brand Name (as it appears on the label) DBA/Trade Name YES NO List the wholesaler(s) for this brand or indicate direct to consumer 1. List the geographic area(s) assigned to each wholesaler 2. 3. 4. Individual Product Brand Name (as it appears on the label) DBA/Trade Name YES NO List the wholesaler(s) for this brand or indicate direct to consumer 1. List the geographic area(s) assigned to each wholesaler 2. 3. 4. Individual Product Brand Name (as it appears on the label) DBA/Trade Name YES NO List the wholesaler(s) for this brand or indicate direct to consumer 1. List the geographic area(s) assigned to each wholesaler 2. 3. 4. Individual Product Brand Name (as it appears on the label) DBA/Trade Name YES NO List the wholesaler(s) for this brand or indicate direct to consumer 1. List the geographic area(s) assigned to each wholesaler 2. 3. 4. Individual Product Brand Name (as it appears on the label) DBA/Trade Name YES NO List the wholesaler(s) for this brand or indicate direct to consumer 1. List the geographic area(s) assigned to each wholesaler 2. 3. 4. Individual Product Brand Name (as it appears on the label) DBA/Trade Name YES NO List the wholesaler(s) for this brand or indicate direct to consumer 1. List the geographic area(s) assigned to each wholesaler 2. 3. 4. American LegalNet, Inc. www.FormsWorkFlow.com