If an exporter desires to return wine to a bonded wine cellar or wholesale liquor dealer as provided in § 28.219, he shall file a notice, executed under the penalties of perjury, with the appropriate TTB officer. The notice shall be prepared in triplicate for submission to the customs official as required in § 28.220a. The notice shall show the:
Name, address, and registration number of the bonded wine cellar from which withdrawn;
Date and serial number of the Form 1582-A (5120.24) on which the wine was withdrawn;
Present location of the wine to be returned;
Number, size and identification of the containers;
Total wine gallons for each tax class of wine; and
Reason for the return.