Information Collection

Report of Wine Premises Operations

IC 39127 under ICR 202010-1513-010 · OMB 1513-0053.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1513-0053 can be found here:

Documents and Forms

Document Name Document Type
Form TTB F 5120.17sm Report of Wine Premises Operations Form and Instruction
TTB F 5120.17sm Report of Wine Premises Operations TTB F 5120.17sm.pdf www.ttb.gov/forms & www.pay.gov/public/login Form and Instruction
TTB F 5120.17sm Report of Wine Premises Operations TTB F 5120.17sm.pdf www.ttb.gov/forms & www.pay.gov/public/login Form and Instruction
TTB F 5120.17sm Te Report of Wine Premises Operations TTB F 5120.17sm-temp.pdf www.ttb.gov/forms & www.pay.gov/public/login Form and Instruction
TTB F 5120.17sm Te Report of Wine Premises Operations TTB F 5120.17sm-temp.pdf www.ttb.gov/forms & www.pay.gov/public/login Form and Instruction
TTB Smart Form User Guide (TTB P 5000.15 (04-2015)).pdf TTB Smart Form User Guide IC Document
TTB Smart Form User Guide (TTB P 5000.15 (04-2015)).pdf TTB Smart Form User Guide IC Document
Tutorial for TTB F 5120.17.docx Tutorial for TTB F 5120.17 IC Document
Tutorial for TTB F 5120.17.docx Tutorial for TTB F 5120.17 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Report of Wine Premises Operations	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 27 CFR 24.65, 24.75, 24.136 27 CFR 24.140, 24.176, 24.197 27 CFR 24.237, 24.268 27 CFR 24.292 - 24.295 27 CFR 24.300, 24.303 27 CFR 24.313, 24.316 27 CFR 28.126

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 5120.17sm	Report of Wine Premises Operations	TTB F 5120.17sm.pdf	https://www.ttb.gov/forms & https://www.pay.gov/public/login	Yes	Yes	Fillable Fileable
Form and Instruction	TTB F 5120.17sm Temp	Report of Wine Premises Operations	TTB F 5120.17sm-temp.pdf	https://www.ttb.gov/forms & https://www.pay.gov/public/login	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12,200	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 35 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	52,870	21,315	31,555
Annual IC Time Burden (Hours)	58,157	23,446	34,711
Annual IC Cost Burden (Dollars)	34,365	34,365	0

Documents for IC

Title	Document	Date Uploaded
TTB Smart Form User Guide	TTB Smart Form User Guide (TTB P 5000.15 (04-2015)).pdf	11/18/2020
Tutorial for TTB F 5120.17	Tutorial for TTB F 5120.17.docx	11/18/2020

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