1513-0001 Ss

-4-

DEPARTMENT OF THE TREASURY

ALCOHOL AND TOBACCO TAX AND TRADE BUREAU

Supporting Statement – Information Collection Request

OMB Control Number 1513-0001

TTB F 5000.19 – Tax Information Authorization

A. JUSTIFICATION

1. What are the circumstances that make this collection of information necessary and what legal or administrative requirements necessitate the collection?

TTB F 5000.19 is used by TTB personnel as evidence of authority for a respondent's (taxpayer, permittee, licensee) representative to see the respondent's tax related information which would not normally be available without the respondent being physically present. This is used particularly when the respondent's representative does not have a power of attorney filed with TTB to receive and examine the respondent's tax information.

Part I of TTB F 5000.19 authorizes TTB to disclose confidential tax information to a person of the respondent's choosing. The authorization is normally prepared during a conference between TTB and the respondent, a conference at which the respondent's representative will discuss the respondent's tax information. TTB's ability to establish this authorization is derived from 5 U.S.C. 500, and 26 CFR 601.502 and 601.503.

26 CFR 601.523 provides that persons who represent an industry member in conference must submit in lieu of a power of attorney, evidence of recognition to practice and that, in the case of a qualified attorney or certified public account, the evidence may consist of a written declaration of the type contained in Part II of TTB F 5000.19. By putting the declaration on the form, TTB has simplified the qualification process. The industry member's representative need not prepare a separate written declaration, but need only check the appropriate box, sign and date the form.

2. How, by whom and for what purpose is this information used?

We use TTB F 5000.19 to ensure that tax related information is not received

by unauthorized persons claiming to represent a respondent. The form identifies the

respondent, the respondent's representative, and the limits of the representative's

authority in tax matters, and provides a format for which a respondent can designate a

representative in tax matters with TTB.

3. To what extent does this collection of information involve the use of automated, electronic, mechanical, or other technological collection techniques or other forms of information technology? What consideration is given to use information technology to reduce burden?

TTB will approved on a case-by-case basis, the use of improved information technology for the submission of this information.

4. What efforts are used to identify duplication? Why can’t any similar information already available be used or modified for use for the purposes described in Item 2 above?

The Federal Information Locator System (FILS) program has been terminated for agency use. However, we search an agency subject classification system to identify any duplication. No similar information is available from any other sources.

5. If this collection of information impacts small businesses or other small entities,

what methods are used to minimize burden?

This collection of information is not susceptible to reduced requirements for small business.

6. What consequences to Federal program or policy activities and what, if any, technical or legal obstacles to reducing burden will occur if this collection is not conducted or is conducted less frequently?

If we did not request the completion of this form, then TTB could find itself disclosing information to unauthorized persons in violation of 26 U.S.C. 6103.

7. Are there any special circumstances associated with this information collection?

There are no special circumstances associated with this collection.

8. What effort was made to notify the general public about this collection of information?

A 60-day notice was published in the Federal Register (72 FR 31368) on Wednesday, June 6, 2007. The notice solicited comments from the general public. TTB received no comments in response to this notice.

9. What decision was made to provide any payment or gift to respondents, other than reenumeration of contractors or grantees?

No payment or gift is associated with this information collection.

10. What assurance of confidentiality was provided to respondents and what was the basis for the assurance in statute, regulations, or agency policy?

We maintain these records in secure file rooms with controlled public access. This information is also subject to protection under 26 U.S.C. 6103 and 5 U.S.C. 552.

11. What justification is there for questions of a sensitive nature?

We ask no questions of a sensitive nature.

12. What is the estimated hour burden of this collection of information?

There is no new burden associated with this collection. We estimate that 50 respondents file this form once per year and that each request requires 1 hour to prepare.

13. What is the estimated total annual cost burden to respondents or recordkeepers resulting from this collection of information?

There is no cost associated with this collection.

14. What is the annualized cost to the Federal government?

Estimates of annual cost to the Federal government are as follows:

Printing 280

Distribution 310

Clerical Costs 671

Other Salary (review

supervisory, etc.) 1,235

TOTAL 2,496

15. What is the reason for any program changes or adjustments reported in Items 13 or 14 of the OMB Form 83-I?

There are no program changes or adjustments associated with this collection.

16. Outline plans for tabulation and publication for collections of information whose results will be published.

The results of this collection will not be published.

17. If seeking approval to not display the expiration date for OMB approval of this information collection, what are the reasons that the display would be inappropriate?

We will display the expiration date of OMB approval for this collection.

18. What are the exceptions to the certification statement?

There are no exceptions to the certification statement.

B. Collection of Information Employing Statistical Methods

This collection does not employ statistical methods.