Name/Title
Legal DocumentsEntry/Object ID
Q2022.21.214Scope and Content
Completed Form 1541 Department of the Treasury - Internal Revenue Service. REGISTRATION FOR PRODUCTION OF WINE FOR FAMILY USE. Submitted by Wilbur P. McDonald, M. D. on Apr. 3, 1974. Stamped "Received Apr. 3, 1974 Regional Director, Bureau of Alcohol, Tobacco, and Firearms, Chicago, Illinois".
INSTRUCTIONS and PERTINENT REGULATIONS are printed on the back of the page.Context
Part I - NOTICE OF REGISTRATON
1. I intend to begin production of not more than 200 gallons of wine annually, solely for my family use, on or about the date indicated at right DATE August 1, 1974
2. The wine will be produced at (Number, Street, City, State, ZIP Code. If rural address . . . . . )
6 Country Club Road
St. Joseph, Missouri . . .
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Yes No
3. Are you head of a family? x 6. I understand the filing of this notice - - -
4. Are you single? x (a) does not give you authority to sell . . . .
If so, do any dependents. . (b) does not give you authority to make . . .
5. Are you married? x in partnership . . .
If so, do wife (husband) or (c) does not give you authority to make . . . for a
. . dependents live with you x person not a member of my family.
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7. I understand . . . . penalties imposed by internal revenue law.
8. Under penalty of perjury . . . it is true, correct, and complete.
DATE April 3, 1974 SIGNATURE __________________
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PART II - WINE PRODUCTION (this is hand-written in blue ink)
Date (a) Kind (Grape, blackberry . . ) (b) Gallons (c)
Fall 1974 Elvira 5
" S.V. 5-276 5
" S.V. 5-247 5
" Siebel 13053 5
" Siebel 10878 5
" Virginia Seedling 5
______________________________________________________________________________________Lexicon
Nomenclature 4.0
Nomenclature Sub-Class
Legal DocumentsNomenclature Class
Documentary ObjectsNomenclature Category
Category 08: Communication ObjectsDimensions
Dimension Notes
8" x 10.5"