Information Collection

Certificate of Taxpaid Alcohol

IC 187802 under ICR 201902-1513-001 · OMB 1513-0131.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1513-0131 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form TTB F 5100.4 Certificate of Taxpaid Alcohol	Form and Instruction
TTB F 5100.4 Certificate of Taxpaid Alcohol TTB F 5100.4 (11-2015).pdf www.ttb.gov/forms/5000.shtml	Form and Instruction

IC Title:

Certificate of Taxpaid Alcohol

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 27 CFR 17.181

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	TTB F 5100.4	Certificate of Taxpaid Alcohol	TTB F 5100.4 (11-2015).pdf	https://www.ttb.gov/forms/5000.shtml	Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	10	-990	1,000
Annual IC Time Burden (Hours)	5	-495	500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.