- 1 - Y: FORM C-716 (01/2019) APPLICATION FOR DESTRUCTION OF ALCOHOLIC BEVERAGES Date: Contact Person: Trade name: Telephone # FAX #: CLP #: Email: City: Alcoholic Beverages to be destroyed must be separated by type as indicated below. TABC APROVAL Exhibit A - Beer Gallons Approved: Exhibit B - Ale or Malt Liquor Gallons Approved: Exhibit C - Wine or Distilled Spirits Gallons Approved: Upon approval, the destruction is scheduled to take place on at (date) time) Destruction Location Name: Address: City: State Method of Destruction: Reason for Destruction: The information contained in this application for destruction is true and correct to the best of my knowledge. TABC USE ONLY: ARTS # AUDIT # Signature Print or Type Name Title APPROVED: TABC Representative Date American LegalNet, Inc. www.FormsWorkFlow.com - 2 - INSTRUCTIONS 226 SEE REVERSE SIDE FORM C-716 (01/2019) DESTRUCTION OF ALCOHOLIC BEVERAGES INSTRUCTIONS 1. IMPORTANT: Prepare a separate exhibit for distilled spirits and wine, beer, or ale and malt liquor. 2. A copy of this Form C-716 must be sent to your nearest Texas Alcoholic Beverage Commission office by mail, facsimile or email to the attention of the Audit Supervisor. Call your designated Regional TABC Office to obtain their email or fax. Written approval for the destruction via this form must be received by the TABC Office in time to allow at least three business days (M - F) prior to the proposed destruction date. For large destructions, a computerized listing of the products to be destroyed may be attached providing the required information to include quantity, brand description, type (beer, wine, DS, etc.) and package size (24/12, 750 ml., etc.) 3. Upon receipt of the application, the TABC Office will review and calculate the gallons related to the destruction. An approved copy of the form will be returned to the permit or license holder authorizing the destruction. Based on the size of the destruction and additional factors, TABC may elect to physically witness the destruction and will contact your representative to arrange to inspect the merchandize prior to authorizing the destruction. 4. If TABC elects not to witness the destruction, it will be necessary for a representative of the permit or license holder to witness the destruction and prepare an affidavit of the destruction for documentation purposes. A copy of Form C-716 along with attached inventory documents (exhibits) and internal affidavit should be filed with permit or license holder222s file for documentation and future audit purposes. 5. If the merchandise was destroyed off your licensed premises, a receipt signed and dated by a representative of the landfill or other location where the merchandise was destroyed should also be attached to your file copy and retained for audit purposes. 6. One executed copy of Form C-716, without support documents, should be attached to the permit or license holder222s monthly excise tax report submitted to TABC HQ to support the destruction claimed. Failure to maintain the required support documentation may result in the claim being disallowed during a TABC audit. Exhibit A 226 Beer to be Destroyed (Separate forms must be prepared for beer or ale and malt liquor.) 7. 223Brand224 - refers to the name reflected on the product label. 8. 223Packages to be Destroyed224 - refers to the number of containers per package and the size of the container (i.e. 275 bbl., 24/16 oz., 24/12 oz., etc.). List the number of cases under the proper size on the exhibit. If less than a case is destroyed, show the bottles destroyed as a fraction of the original case size (e.g. 6 twelve ounce bottles destroyed which were out of a 24/12 oz. case will be shown as 6/24 under the 24/12 oz. column.) 9. 223Miscellaneous Sizes224 - show any package sizes destroyed that are not preprinted on the appropriate form (i.e. 12/33.8 oz., 48/7 oz., etc.). 10. 223Total224 - show totals for any package sizes that have entries. 11. Additional exhibits may be used if destruction size requires it. Any additional pages used should be numbered 1 of 3, 2 of 3, etc. and a grand total of all pages must be shown. For large destructions, a computerized listing may be attached to support the totals. The listing must reflect the required information shown on the individual form. Exhibit B 226 Ale or Malt Liquor to be Destroyed American LegalNet, Inc. www.FormsWorkFlow.com - 3 - (Separate forms must be prepared for beer or ale and malt liquor.) 12. 223Brand224 - refers to name reflected on the product label. 13. 223Packages to be Destroyed224 - refers to the number of containers per package and the size of the container (i.e. 275 bbls., 24/16 oz., 24/12 oz., etc.). List the number of cases under the proper size on the exhibit. If less than a case is destroyed, show the bottles destroyed as a fraction of the original case size (e.g. 6 twelve ounce bottles destroyed which were out of a 24/12 oz. case will be shown as 6/24 under the 24/12 oz. column.) 14. 223Miscellaneous Sizes224 - show any package sizes destroyed that are not preprinted (i.e. 12/12 oz., 48/7 oz., etc.). 15. 223Total224 - show totals for any package sizes that have entries. 16. Additional exhibits may be used if destruction size requires it. Any additional pages used should be numbered 1 of 3, 2 of 3, etc. and a grand total of all pages must be shown. For large destructions, a computerized listing may be attached to support the totals. The listing must reflect the required information shown on the individual form. Exhibit C 226 Distilled Spirits and/or Wine to be Destroyed 17. 223Class of Beverage224 should indicate distilled spirits, low wine, high wine, sparkling wine, or distilled spirit miniatures. 18. 223Cases or Bottles224 should indicate the number of cases to be destroyed. If items to be destroyed are less than one case indicate the number of bottles to be destroyed. 19. 223Bottle Size224 indicates the size container in which the distilled spirits or wine is packaged (750 ml., liter, 1.75 liter, etc.). 20. 223Bottles per Case224 indicates the number of bottles in each case to be destroyed. If the items shown in the column titled 223Cases or Bottles224 are bottles, leave this column blank for that item. 21. 223Wine Gallons per Unit224 represents the wine gallons per case if cases are used in the column titled224 Cases or Bottles224 or the wine gallons per bottle if bottles were use. This column is left blank if 223Class of Beverage224 reflects distilled spirits miniatures. 22. The four columns shown under 223Wine Gallons224 should reflect the product of the amounts entered 223Cases or Bottles224 times 223Wine Gallons per Unit224. The product should be entered in the column corresponding with the entry in the column titled 223Class of Beverage224. 23. 223Distilled Spirits Miniatures224 should reflect the total number of bottles (units) of distilled spirits miniatures to be destroyed. This total will be the product of the entry in the column titled 223Cases or Bottles224 multiplied by the amount entered under the column titled 223Bottles per Case224. For large destructions, a computerized listing may be attached to support the totals. The listing must reflect the required information shown on the individual form. American LegalNet, Inc. www.FormsWorkFlow.com - 4 - EXHIBIT A 226 BEER TO BE DESTROYED Brand Packages to be Destroyed Miscellaneous Sizes 1/2 bbl. 12/32 oz. 24/ 12 oz. 24/ 16 oz. TOTAL American LegalNet, Inc. www.FormsWorkFlow.com - 5 - EXHIBIT B 226 ALE AND MALT LIQUOR TO BE DESTROYED Brand Packages to be Destroyed Miscellaneous Sizes 275 bbl. 12 / 40 oz. 24/32 oz. 24/16 oz. 24/12 oz. TOTAL American LegalNet, Inc. www.FormsWorkFlow.com - 6 - EXHIBIT C 226 WINE AND DISTILLED SPIRITS TO BE DESTROYED Class of Beverage Cases or Bottles Bottle Size Bottles Per Case Wine Gallons Per Unit Wine Gallons Distilled Spirits Miniature Distilled Spirits Low Wine High Wine Sparkling Wine TOTAL American LegalNet, Inc. www.FormsWorkFlow.com - 7 - STATE OF TEXAS COUNTY OF TRAVIS INTERNAL DESTRUCTION AFFIDAVIT Trade name: CLP Number: Date: Address: City: THAT, I, , an authorized representative of the above license or