OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Authorization to Furnish Financial Information and Certificate of Compliance

ICR 201512-1513-001 · OMB 1513-0004 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form TTB F 5030.6 Authorization to Furnish Financial Information and Certificate of Compliance Form and Instruction Modified Available
1513-0004 Supporting Statement (2015-12-17).docx Supporting Statement A Uploaded 2015-12-17 Available
IC Document Collections
IC IDCollectionTypeStatusForm
43832 Authorization to Furnish Financial Information and Certificate of Compliance Form and Instruction Modified
ICR Details
1513-0004 201512-1513-001
Historical Active 201210-1513-001
TREAS/TTB IC 55 2/3
Authorization to Furnish Financial Information and Certificate of Compliance
Revision of a currently approved collection   No
Regular
Approved without change 03/11/2016
Retrieve Notice of Action (NOA) 12/31/2015
  Inventory as of this Action Requested Previously Approved
03/31/2019 36 Months From Approved 03/31/2016
240 0 2,000
60 0 500
0 0 0
The TTB regulations require applicants for alcohol and tobacco permits to provide certain information regarding the money used to finance the business. The Right to Financial Privacy Act of 1978 (the Act; 12 U.S.C. 3401 et seq.) limits government access to records held by financial institutions, provides for certain procedures to gain access to such information, and requires that government agencies certify to a financial institution that the agency has complied with all provisions of the Act. To comply with the requirements of the Act, TTB F 5030.6 acts as both a customer authorization to their financial institution providing TTB with the authority to receive the customer’s financial information and as the required certification by TTB to the financial institution that it has complied with the Act’s provisions.
US Code: 12 USC 3401-3422 Name of Law: Right to Financial Privacy Act of 1978
   US Code: 26 USC 5171 and 5271 Name of Law: Internal Revenue Code
   US Code: 26 USC 5712-5713 Name of Law: Internal Revenue Code
   US Code: 27 USC 203-204 Name of Law: Federal Alcohol Administration Act
  
None
Not associated with rulemaking
  80 FR 52093 08/27/2015
80 FR 81882 12/31/2015
No
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 240 2,000 0 0 -1,760 0
Annual Time Burden (Hours) 60 500 0 0 -440 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
As an adjustment, we are revising the burden estimate to reflect a decrease in the number of respondents who complete TTB F 5030.6 and the resulting burden hours due to a decrease in the number of permit application investigations conducted by TTB that require access to records concerning applicants held by financial institutions.
$950
No
No
No
No
No
Uncollected
Michael Hoover 202 453-2135 ext. 135 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
12/31/2015