1513-0131 Ss (09-30-2012)

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DEPARTMENT OF THE TREASURY

ALCOHOL AND TOBACCO TAX AND TRADE BUREAU (TTB)

Supporting Statement – Information Collection Request

OMB Control Number – 1513-0131

TTB F 5100.4 - CERTIFICATE OF TAXPAID ALCOHOL

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.

Under 27 CFR 17.181, medicinal preparations and flavoring extracts, approved for drawback under the provisions of part 17, may be exported subject to

19 U.S.C. 1313(d), which authorizes export drawback equal to the entire amount of internal revenue tax found to have been paid on the domestic alcohol used in the manufacture of such products. Claims for such export drawback must be filed in accordance with the applicable regulations of Customs. Such claims may cover either the full rate of tax which has been paid on the alcohol, if no nonbeverage drawback has been claimed thereon, or else the remainder of the tax if nonbeverage drawback under 26 U.S.C. 5114 has been or will be claimed.

In this information collection, the remainder of the tax claimed for nonbeverage drawback is what is submitted on TTB F 5100.4. The industry member pays taxes of $13.50 for each proof gallon of alcohol used in the manufacture of nonbeverage products. The industry member submits claims to TTB to receive back $12.50 for each proof gallon of alcohol used in manufacture of nonbeverage products on TTB F 5630.8 (1513-0030). If the nonbeverage product is exported the industry member submits TTB F 5100.4 to TTB with supporting documents. TTB certifies that the taxes have been paid and not refunded. The certified form and supporting documents are sent to the Director of Customs to be processed and for the refund of the remaining $1.00 paid in excise taxes.

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: None

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

The information collected on TTB F 5100.4 is passed on to the Director of Customs and used to process claims. TTB keeps a copy of the form on file to compare with future submission, to prevent duplication.

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 the use of improved technology on a case-by-case basis.

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

Similar information is not available elsewhere for this information collection requirement. Each shipment of exported products is unique and needs to be processed separately. We are not aware of any duplication.

5. If this collection of information impacts small businesses or other small entities, what methods are used to minimize burden?

All applicants, regardless of size, are required by Customs to submit this form. The minimal information mandated by the form cannot be waived or reduced simply because the respondent’s business 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?

If this collection was not conducted it would mean that claimants would not receive back the $1.00 paid in taxes, which could result in a significant loss, over the years, for those industry members that conduct a large number of exports. .

7. Are there any special circumstances associated with the information collection that would require it to be conducted in a manner inconsistent with OMB guidelines?

There are no special circumstances associated with this information 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, June 29, 2012, 77 FR 38886. 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, or than re-enumeration of contractors or grantees?

No payment or gift is associated with this collection.

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

No specific assurance of confidentiality is provided on this form; however, the confidentiality of the information collected on this form is protected by 26 U.S.C. 6103.

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

No questions of a sensitive nature are asked.

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

It is estimated that 10 respondents will file 100 TTB F 5100.4 annually. This form is submitted by industry members that export nonbeverage products and wish to received back $1.00 for each proof gallon exported. The average time to prepare the form and make any corrections is 30 minutes per form. That would be a total of 1,000 responses and 500 annual burden hours.

13. What is the estimated total annual cost burden to respondents or record

keepers resulting from this collection of information (excluding the value of the burden hours in Question 12 above?

No cost is 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 $ 20.00

Distribution 25.00

Clerical Cost 30.00

Other Salary (review,

supervisory, etc) 1,500.00

$1,575.00

15. What is the reason for any program changes or adjustments?

There is an adjustment associated with this information collection as a result of a correction to the time it takes to complete this form. In the past the Supporting Statement reported 1 hour to complete this form and at the same time the PRA Notice on the form reported 30 minutes. The correct amount of time is 30 minutes which reduces the burden hours by 500.

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

We will not publish the results of this collection.

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 item 5 above

(f) This is not a recordkeeping requirement

(i) No statistics are involved

(j) See item 3 above.

B. Collections of Information Employing Statistical Methods.

This collection does not employ statistical methods.