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DEPARTMENT OF THE TREASURY
ALCOHOL AND TOBACCO TAX AND TRADE BUREAU
Supporting Statement – Information Collection Request
OMB Control Number 1513-0003
TTB F 5000.21 - Referral of Information
A. Justification
1. What are the circumstances that make this collection of information necessary and what legal or administrative requirements necessitate the collection? Also include the following: Align the information collection to Treasury’s Strategic Goals, Line of Business/Sub-function, and IT Investment, if one is used.
In performing the mission of the Bureau, TTB personnel often discover apparent violations of statutes and regulations of other Federal, State, and local agencies. Information on such violations is referred to the agency having jurisdiction. The form used to refer such information to other agencies includes a section for the other agency to respond regarding their action on the referral. This information assists TTB in determining the value of the information to the other agency, in order to evaluate our referral system. The form is also used internally between different TTB divisions.
This information collection is aligned with:
Treasury Strategic Goal: Effectively Manage US Government Finances.
Line of Business/Sub-function: General Government/Taxation Management.
IT Investment: Tax Major Application Systems.
2. How, by whom and for what purpose is this information used?
The referral is an evaluation and communication tool which provides TTB to a consistent means of providing other agencies with relevant information and facilitates information-sharing between agencies to support enforcement efforts. The response that TTB requests from other agencies also provides information as to the utility of the referral and potential enforcement actions by other agencies against the same entities TTB may regulate.
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?
This form is completed in parts by TTB and the respondent, there is little chance that this form can be involved in the use of automated, electronic, mechanical, or other technological collection techniques, however, TTB will consider on a case-by-case basis the use of different technologies.
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?
TTB F 5000.21 is a voluntary request for information that is pertinent only to the Federal, State, or local agency to whom information is referred. The information provided is always unique to the respondent. As far as we can determine, similar information is not available elsewhere.
5.
If this collection of information impacts small businesses or
other small entities, what methods are used to minimize burden?
The information requested is the least information needed to meet the stated goal. All entities are asked voluntarily to provide information, regardless of their size.
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?
Without this information, TTB would not have a standardized vehicle to notify the pertinent agency with regard to potential civil and criminal violations and receive a response, and we would not be able to determine the value of the information to the agencies.
7. Are there any special circumstances associated with this information collection that would require it to be conducted in a manner inconsistent with OMB guidelines?
There are no special circumstances associated with this collection.
8. What effort was made to notify the general public about this collection of information? Summarize the public comments that were received and describe the action taken by the agency in response to those comments.
A 60-day Federal Register notice was published for this information collection on Friday, January 31, 2014, at 79 FR 5526. The notice solicited comments from the general public. TTB received no comments.
9. What decision was made to provide any payment or gift to respondents, other than remuneration 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?
No specific assurance of confidentiality is provided on this form; however, 26 U.S.C. 6103 protects the confidentiality of information collected under the Internal Revenue Code of 1986.
11. What justification is there for questions of a sensitive nature?
We ask no questions of a sensitive nature; No personally identifiable information (PII) is collected.
12. What is the estimated hour burden of this collection of information?
TTB estimates that there are 500 respondents and each of the 500 respondents (300 Federal and 200 State, Local or Tribal Governments),files 1 form each year. It takes 1 hour to prepare the form. The estimated number of hours per response, the number or respondents, and the number of forms filed annually by each are based on historical data provided by office personnel who process this form.
13. What is the estimated total annual cost burden to respondents or recordkeepers
resulting from this collection of information (excluding the value of the burden hours in
Question 12 above?
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 and Distribution: $ 150*
Clerical Costs: $ 671
Other Salary (review,etc) $1,894
TOTAL $2,715
* Form printing for TTB has dropped off significantly over the years due to the availability of
our forms on TTB.gov. There is sporadic form printing when an Industry Member calls to request a hard copy because they do not have a printer or Internet access. Also, with the small number of respondents For these reasons, TTB incurs sporadic printing and distribution charges for this form.
15. What is the reason for any program changes or adjustments?
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?
(c) See answer 5 above.
(f) This is not a recordkeeping requirement.
(i) No statistics are involved.
(j) See answer 3 above.
B. Collection of Information Employing Statistical Methods
This collection does not employ statistical methods.
| File Type | application/msword |
| Author | ATF |
| Last Modified By | Wolfgang, Dawn |
| File Modified | 2014-03-31 |
| File Created | 2014-03-31 |