View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 1513-0003	ICR Reference No: 201705-1513-002
Status: Historical Active	Previous ICR Reference No: 201403-1513-002
Agency/Subagency: TREAS/TTB	Agency Tracking No: ICN 62 5/8
Title: Referral of Information
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/22/2017
	Date Received in OIRA: 05/30/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2020	36 Months From Approved	08/31/2017
Responses	100	0	500
Time Burden (Hours)	100	0	500
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	100	500	-300	-100
Annual Time Burden (Hours)	100	500	-300	-100
Annual Cost Burden (Dollars)	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: TTB is removing the previously-reported 300 responses from Federal agencies from this information collection request since the use of TTB F 5000.21 internally within the Federal government is not subject to the Paperwork Reduction Act. In addition, based on current information provided by TTB divisions that use this form, TTB is decreasing the number of State and local government responses from 200 to 100, due to a decrease in the use of this form by TTB.

Annual Cost to Federal Government: $3,200

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Michael Hoover 202 453-2135 ext. 135 michael.hoover@ttb.gov

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