Product Registration

Use Standard Quotation and Specification Form [ PDF ] [ Excel ]

Bottle Label or image of Bottle Label must accompany Standard Quotation and Specification Form.

Submit product registration to the Mississippi ABC Purchasing Department, P.O. Box 540, Madison, MS 39130-0540.

Questions? Call 601-856-1342

Instructions for Standard Quotation and Specification Form. Form must be completely filled out except where otherwise indicated.

  • Vendor of Record (Supplier Name)
  • Line 1 State (Mississippi)
  • Line 2 Date Submitted
  • Line 3 Brand (product description)
  • Line 4 Effective Date
  • Line 5 State Plan (Not applicable)
  • Line 6 Bailment (Check line 6 or line 7)
  • Line 7 Special Purchase Order Plan (Check line 6 or line 7)
  • Line 8 Type (Spirit, Still Wine, Sparkling Wine)
  • Line 9 Class (Spirit type, e.g., vodka, bourbon or Wine type, e.g., chardonnay, merlot)
  • Line 10 Not Required
  • Line 11 Age/Vintage (age or vintage when appropriate)
  • Line 12 Proof/Alcohol (Alcohol proof for distilled spirits, percent % alcohol for wines)
  • Line 13 Domestic (Check line 13 or line 14)
  • Line 14 Imported (Check line 13 or line 14)
  • Line 14a INBOND __Yes __No (Check No)
  • Line 15 Distilled/Produced by:
  • Line 16 Address:
  • Line 17 Not Required
  • Line 18 Not Required
  • Line 19 Not Required
  • Line 20 Ship Point (U.S. ship point)
  • Line 21 FOB Point (Ship point if freight collect. destination - Madison, MS if freight prepaid) Must be FOB destination (Mississippi) if vendor has products in bailment.
  • Line 22 Not Required
  • Lines 23 through 31 Check if applicable
  • Line 32 Unit Pack (Bottles per case)
  • Line 33 Not Required
  • Line 34 Not Required
  • Line 35 Not Required
  • Line 36 Not Required
  • Line 37 SCC14 or GTIN bar codes - More information on SCC14/GTIN14 bar codes can be found at http://gtin.info/.
  • Line 38 NABCA Control State code or State code - More info on NABCA codes at http://www.nabca.org/States/Forms.aspx​
  • Line 40 Case Weight (LBS)
  • Line 47 Total Invoice Cost (per case)
  • Line 48 Case Dimensions (L/W/H)(Inches)
  • Line 57 Representative for the State
    • Name
    • Address
    • Not Required: Lic No:
    • Telephone:
    • Fax or email
  • Line 58 Supplier
    • State Lic/Permit No.:
    • Not Required: Fed ID No.:
    • Address:
    • Telephone:
    • Fax or Email
    • By: (Print Name followed by email address or signature)
    • Title:
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