Authorization to Furnish Financial Information and Certificate of Compliance

ICR 200909-1513-001

OMB: 1513-0004

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supplementary Document
2009-09-03
Supplementary Document
2009-09-03
Supporting Statement A
2009-09-03
ICR Details
1513-0004 200909-1513-001
Historical Active 200607-1513-003
TREAS/TTB
Authorization to Furnish Financial Information and Certificate of Compliance
Extension without change of a currently approved collection   No
Regular
Approved without change 10/27/2009
Retrieve Notice of Action (NOA) 09/16/2009
  Inventory as of this Action Requested Previously Approved
10/31/2012 36 Months From Approved 10/31/2009
2,000 0 2,000
500 0 500
0 0 0

The Right to Financial Privacy Act of 1978 limits access to records held by financial institutions and provides for certain procedures to gain access to the information. TTB F 5030.6 serves as both a customer authorization for TTB to receive information and as the required certification to the financial institution.

None
None

Not associated with rulemaking

  74 FR 26920 06/04/2009
74 FR 47039 09/14/2009
No

  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 2,000 2,000 0 0 0 0
Annual Time Burden (Hours) 500 500 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$2,123
No
No
Uncollected
Uncollected
No
Uncollected
Mary Wood 202 927-8185 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
09/16/2009


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