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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?
In performing the mission of the Bureau, TTB personnel often discover violations of statutes and regulations of other Federal, State, and local agencies. Information on criminal and civil violations under the jurisdiction of TTB, and of other Federal, State, or local agencies are referred to the agency having jurisdiction. The agency to which the information is referred is requested on the form to respond to the information so that TTB can determine the value of the information to the agency.
This information collection is aligned with:
Treasury Strategic Goal: Effectively Manage US Government Finances. None.
Line of Business/Sub-function: General Government/Taxation Management.
IT Investment: Tax Major Application Systems. None.
2. How, by whom and for what purpose is this information used?
The referral is an evaluation and communication process which furnishes to TTB or other agencies all of the available information relevant to a decision as to (1) whether criminal prosecution or other action is warranted and/or desirable, and (2) how additional information may be obtained.
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 consider on a case-by-case basis the use of improved technology.
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 with information collected that
is pertinent only to the Federal, State, or local agency that has information referred to it. 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?
TTB does not use any method to minimize the burden since all entities regardless of size, are requested to complete the information. This cannot be waived simply because the respondent's size is small.
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?
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 Federal Register notice was published for this information collection on Tuesday, September 28, 2010, at 75 FR 59797. 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 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?
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.
12. What is the estimated hour burden of this collection of information?
Each of the 500 respondents file 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?
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 $ 211
Distribution 200
Clerical Cost A 93
Other salary (review,
supervisory, etc.) 1,814
TOTAL $2,318
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.
| File Type | application/msword |
| Author | ATF |
| Last Modified By | TTB |
| File Modified | 2010-11-03 |
| File Created | 2010-11-01 |