OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Drug Experience Report (short Form)

IC 165366 under ICR 198006-0910-002 · OMB 0910-0026.

Documents and Forms
Document Name
Document Type
No indexed documents/forms are available for this IC yet. A refresh has been queued.
Information Collection (IC) Details

View Information Collection (IC)

DRUG EXPERIENCE REPORT (SHORT FORM)
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form FD 1639A No No


    

31,500 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 31,500 0 0 0 0 31,500
Annual IC Time Burden (Hours) 2,625 0 0 0 0 2,625
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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