SD EForm - 0869 V7 Revised /1 State of South Dakota Alcoholic Beverage Brand - Label Registration Application South Dakota Department of Revenue Special Tax Division 445 E. Capitol Ave | Pierre, SD 57501-3100 Applicant Name: Mailing Address: Phone: Fax: Basic Federal Permit No.: E-mail Address: Application is hereby made for the registration of the Alcoholic Beverage Brand-Lab s herein listed which will be offered for sale or held with intent to sell within the State of South Dakota in accordance with Chapter 39-13 and Section 10-1-14( ), South Dakota . Laws for the calendar year: CLASS NUMBER BRAND PRODUCT LABEL % FEE Additional sheets may be attached if required Total Fee: $ 0.00 I, the undersigned, an official of and for the above applicant, do hereby certify that the above products and labels conform to Laws and Regulations of the State of South Dakota applicable to Alcoholic Beverages and have been registered with and approved by the under the Federal Alcohol Administration Act. Date Signed Title For Department Use Application Rec'd: Total Registration Fee Rec'd: Label Registrations Approved: Exceptions: Signed: Special Tax Division, Department of Revenue License No: Additional Fee Due: Denied: Date: SEE INSTRUCTIONS ON REVERSE SIDE SD REV American LegalNet, Inc. www.FormsWorkFlow.com Instructions Classifications (identify classifications by numbers) Registrations Fees Additional Initial Brand-Products Brand Labels Label $25.00 $25.00 $50.00 $17.50 $25.00 $50.00 5 Wines* 6 Malt and Cereal Beverages 7 Distilled Spirits, Whiskeys, Gin, Rum, Brandy, Vodka, Alcoholic Cordials, Liqueurs, Cocktails, etc. NOTE: *The law provides for reduced registration fee when two or more brand labels of the same class of wine are registered by applicant. Note fees. Duplicate brand labels must be provided with this application. American LegalNet, Inc. www.FormsWorkFlow.com Alcohol Brand Registration and Reporting Information In order to market your alcoholic beverage products in the State of South Dakota, they must be first filed and approved by the United States Department of the Treasury, Alcohol and Tobacco Tax and Trade Bureau. After federal approval, the following requirements are to be met for label approval in South Dakota. The following items must be provided by your office if you wish to qualify your company to register and ship alcoholic beverages into the State of South Dakota: 1. A copy of your product's Federal Label Approvals 2. A copy of your product's chemical analysis (if available) 3. Duplicate sets of labels for each brand product registered 4. Application for brand registration approved (done annually) 5. Proper brand registration fee attached to registration application 6. Affidavit from the registered brand owners for brand distribution authority if the brand registration applicants not the owner thereof (NOTE: South Dakota requires that wholesalers receive alcoholic beverages only from the brand owner or his authorized agent.) 7. Distilled Spirits, Wine and Cider suppliers must email the Special Taxes Division with our monthly Excel form to report all sales and samples sold to South Dakota Wholesalers, by the 15th of each month. Please refer to the forms link for the required Distilled Spirits/Wine/Cider Excel file. Note we do not need paper or pdf copies of your invoices. 8. Brewers and beer suppliers must email the Special Taxes Division with our monthly Excel form to report all sales and samples sold to South Dakota Wholesalers, by the 15th of each month. Please refer to the forms link for the required Distilled Spirits/Wine/Cider Excel file. Note we do not need paper or pdf copies of your invoices. State liquor taxes are collected by the State at the wholesale level upon receipt by the wholesaler of all imported alcoholic beverage products. 9. Solicitors License- any person who contacts a wholesaler or retail dealer within this state for the purpose of selling, promoting, or advertising alcoholic beverages or for any other reason connected with the alcoholic beverage industry is required to obtain a Solicitor License (this does not include employees of wholesale or transporter licensees who only deliver such beverages). Go to SD.Gov/TaxApp to apply. American LegalNet, Inc. www.FormsWorkFlow.com