Referral of Information

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1513-0003 can be found here:

Documents and Forms

Document Name Document Type
Form TTB F 5000.21 Referral of Information Form and Instruction
TTB F 5000.21 Referral of Information TTB F 5000.21 (05-2017).pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Referral of Information	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	TTB F 5000.21	Referral of Information	TTB F 5000.21 (05-2017).pdf		Yes	No	Fillable Printable

Line of Business: Law Enforcement

Subfunction: Substance Control

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 125	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	125	25	100
Annual IC Time Burden (Hours)	125	25	100
Annual IC Cost Burden (Dollars)	250	250	0

Documents for IC

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.