1. food and drink
2. beverages
3. alcoholic beverages
4. cocktails and beer

 NEW PRODUCT REGISTRATION FORM AGLC Use Only LOA Date
Registration
Consignment Payee
Reviewed by
LOU Date
System Updates
PLEASE PRINT 1. LIQUOR SUPPLIER INFORMATION (if you have already registered products from this supplier, only the company name is necessary) Company Name: Manufacturer (Primary Supplier) Négociant (Secondary Supplier) Other (specify) Address: PO Box: Province/State: City: Postal/ZIP Code: Country: Telephone: Email: Fax: Website Address: 2. LIQUOR AGENCY INFORMATION *Contact Name: Company Name: Email Address: *Person who will receive AGLC registration confirmation.
Telephone: Fax: Website Address: 3. PRODUCT DESCRIPTIONS / VINTAGE Is this product a line extension? (a different size and/or different bottles per case of an existing listing): If yes, specify Product Code Yes No
Long Name: (Forty (40) character description including spaces and punctuation) Short Name: NOTE: Vintage: (Fifteen (15) character description including spaces and punctuation
‐ for inventory reporting) If this product is for on‐packing only, you must include that note in the description.
(wine only) (if the vintage will “roll over” from year
to year, a “V” can be specified)
4. ALCOHOL BY VOLUME: % (specify percentage)
5. PRODUCT ORIGIN / EXPORT Country of Origin (Production): Region of Origin: Country of Export (Shipped from): Region of Export: 6. PRODUCT CATEGORY/TYPE (place a “check mark” or an “X” in the applicable space) SPIRITS: Armagnac Bitter Liqueur ‐ specify flavour Gin: Dry Flavoured Rum: Dark Flavoured Vodka: Flavoured Regular Whisky: American Canadian If American: Bourbon If Canadian: New Rate Whisky If Scotch: Blended WINE (colour must be selected): Brandy Brandy (fruit)
Cachaça Cognac Grappa Mezcal Misc. Liquor Pre‐Mix Ready‐to‐Drink Holland Light (Amber) White Indian Irish Tennessee Other Scotch Other ‐ specify Old Rate Whisky Tequila Blended Malt Single Malt Blush Red White Type: Aperitif Champagne Crackling Dessert (Fortified): Fruit Wine: Icewine Mead (Honey) Mistelle Vermouth Vodka Ice Wine‐Based Liqueur Madeira Montilla Port Prune Based Not Sparkling Sparkling Sparkling Table Sherry Other ‐ specify Continued on next page
PROTECTED WHEN COMPLETED FORM CS/454‐1 (2015 Mar) Specify Product name again: 6. PRODUCT CATEGORY/TYPE (Continued) KOSHER WINE Dessert Fruit Passover Table Other ‐ specify If Fruit: Not Sparkling Sparkling Prune‐based SAKE Not Sparkling Sparkling BEER (Submit a Declaration of Production if applicable) Standard: Ale Lager Porter Stout Other ‐ specify Unpasteurized: Ale Lager Porter Stout Other ‐ specify REFRESHMENT BEVERAGE: (cannot be > 16% alc./vol.) If Malt: Ale Liquor
Lager Malt
Porter Wine
Stout Sparkling ‐ Pear
Other Fermented Beverage ‐ specify Other ‐ specify CIDER: 7. RESIDUAL SUGAR (expressed in grams/litre) 8. CONTAINERS / PACKAGING / PRESENTATION
a) Individual Single Size: c) Is the product sold in packs? d) What is the container made of (i.e. glass, plastic, can, keg, key keg): e) If BEER BOTTLE, specify bottle type: Industry Standard or refillable – your company must be a signatory of the agreement with Beer Canada or if refillable, specifically registered with the Beverage Container Management Board. f) Is this a beverage gift pack (consisting only of beverage alcohol)? If yes, specify the individual products within the gift pack and provide their Product Codes if available: Sparkling ‐ Apple Yes Not Sparkling ‐ Apple Not Sparkling ‐ Pear (should be completed for WINE)
(ml) b) Total singles per case:
No If YES: Singles Per Pack:
Industry Standard Other Refillable Packs Per Case:
Non‐Refillable Yes No g) Is this a non‐beverage gift pack (consisting of beverage alcohol and non‐alcohol products (i.e., glasses, corkscrews))? Yes No If yes, specify the non‐alcohol portion: h) Does this product have a: i) Does this product include a beverage alcohol on‐pack? Gift Box Gift Tin Gift Decanter If yes, specify Product Code and Product Name of on‐pack: Size:
Also, specify Product Code of base bottle: Size:
9. Is this on‐pack being assembled by: a) If there is an existing Product Code from another liquor jurisdiction, provide it:
b) If a Product Code does not currently exist, we will assign an internal AGLC 6‐digit Product Code: c) Yes Connect Logistics No Supplier PRODUCT CODES (AGLC internal use only)
International Article Numbering/Uniform Code Council EAN/UCC‐13 (single): (formerly U.P.C.) EAN/UCC‐13 (sales unit): (formerly U.P.C.) EAN/UCC‐14: 10. PRIVATE LABEL Is this product a private label?: Yes (ensure a label is attached to this application) No If yes, advise which AGLC registered product, available to all licensees, will be used for the necessary price comparison: (formerly SCC‐14) Product Code: A Private Label is a product with a label that bears a premise‐specific name on the front label and complies with AGLC’s Private Label policy. 11. PRODUCT PRICING a) Invoice Price Per Case: $ b) If Aluminum Keg, does it have a refundable keg deposit? 12. SHIPPING How is this product being shipped to Alberta? SHIPPING If on‐pack attached, please advise if the on‐pack is 13. Description: No Yes If yes, ensure that deposit is included in invoice price Duty Paid Not Applicable Customs: In Bond Not Applicable
Duty Paid Exempt Excise: In Bond Customs: Excise: WAREHOUSER INFORMATION (check one or specify)
Indicate the warehouser for this product: Connect Logistics Services; or
In Bond In Bond Duty Paid Duty Paid Not Applicable
Not Applicable
Exempt
Other (specify): PROTECTED WHEN COMPLETED FORM CS/454‐1 (2015 Mar)