Certificate of Taxpaid Alcohol

Forms and Documents

Document Name	Status
Form TTB F 5100.4 Certificate of Taxpaid Alcohol Form	New
1513-XXXX Laws and Reg.doc Supplementary Document	2009-01-15
1513-XXXX FR Notice (04-25-08).pdf Supplementary Document	2009-01-15
1513-XXXX SS.doc Supporting Statement A	2009-01-15

IC Document Collections

IC ID	Document Title	Status
187802	Certificate of Taxpaid Alcohol Form	New

ICR Details

OMB Control No: 1513-0131	ICR Reference No: 200901-1513-006
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: TREAS/TTB	Agency Tracking No:
Title: Certificate of Taxpaid Alcohol
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/28/2009
	Date Received in OIRA: 08/17/2009
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2012	36 Months From Approved
Responses	1,000	0	0
Time Burden (Hours)	1,000	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: TTB F 5100.4 consolidates taxes paid on distilled spirits used in the manufacture of nonbeverage products for exportation. The form is completed by TTB industry members to receive back $1 for each proof gallon of nonbeverage products exported. The form is certified by TTB as proof that the taxes have been paid and not previously received back. The completed form is sent to the Director of Customs and Border Patrol who processes it and returns the $1 per proof gallon.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 22462	04/25/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 40003	08/10/2009
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Certificate of Taxpaid Alcohol	TTB F 5100.4	Certificate of Taxpaid Alcohol

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,000	0	0	1,000	0	0
Annual Time Burden (Hours)	1,000	0	0	1,000	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: There is a program change because this is a form that has never had OMB approval, thus there is an increase in burden hours.

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Annual Cost to Federal Government: $1,575

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/17/2009

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