Reporting and Recordkeeping for Electronic Products - General Requirements

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 3647 Mercury Vapor Lamp Annual Report	Form and Instruction	Modified	Available
Form 3646 Mercury Vapor Lamp Product Report	Form and Instruction	Modified	Available
Form 3645 Ultrasonic Therapy Annual Report	Form and Instruction	Modified	Available
Form 3644 Ultrasonic Therapy Product Report	Form and Instruction	Modified	Available
Form 3643 Microwave Annual Report	Form and Instruction	Modified	Available
Form 3642 General Correspondence	Form and Instruction	Modified	Available
Form 3641 Cabinet XRay Annual Report	Form and Instruction	Modified	Available
Form 3640 Laser Light Show Product Report	Form and Instruction	Modified	Available
Form 3639 Cabinet XRay System Product Report	Form and Instruction	Modified	Available
Form 3638 Annual Report XRay Components and Systems	Form and Instruction	Modified	Available
Form 3637 Laser Original equipment Manufacturer Report	Form and Instruction	Modified	Available
Form 3636 Laser Light Show Annual Report	Form and Instruction	Modified	Available
Form 3635 Laser Light Show Nodification	Form and Instruction	Modified	Available
Form 3634 TV Annual Report	Form and Instruction	Modified	Available
Form 3633 General Variance Request	Form and Instruction	Modified	Available
Form 3632 Laser Product Report	Form and Instruction	Modified	Available
Form 3631 Sunlamp Annual Report	Form and Instruction	Modified	Available
Form 3630 Sunlamp Product Report	Form and Instruction	Modified	Available
Form 3629 Abbreviated Report	Form and Instruction	Modified	Available
Form 3628 General Annual Report	Form and Instruction	Modified	Available
Form 3627 Diagnostic XRay CT Report	Form and Instruction	Modified	Available
Form 3626 Diagnostic XRay Major Componets Product	Form and Instruction	Modified	Available
Form 3649 Accidental Radiation Occurence	Form and Instruction	Modified	Available
Form 3147 Laser Light Show Variance Application	Form and Instruction	Modified	Available
Form 2767 Notice of Availability-Sample electronic Product	Form and Instruction	Modified	Available
Form 2579 Assembler Report	Form and Instruction	Modified	Available
Form 2877 Declaration of Imported Electronic Products	Form and Instruction	Modified	Available
SS- 0910-0025.DOC	Supporting Statement A	Uploaded 0000-00-00	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Mercury Vapor Lamp Annual Report
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Mercury Vapor Lamp Product Report
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Ultrasonic Therapy Annual Report
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Ultrasonic Therapy Product Report
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Microwave Annual Report
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	General Correspondence
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Cabinet XRay Annual Report
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Laser Light Show Product Report
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Cabinet XRay System Product Report
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Annual Report XRay Components and Systems
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Laser Original equipment Manufacturer Report
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Laser Light Show Annual Report
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Laser Light Show Nodification
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	TV Annual Report
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	General Variance Request
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Laser Product Report
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Sunlamp Annual Report
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Sunlamp Product Report
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Abbreviated Report
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	General Annual Report
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Diagnostic XRay CT Report
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Diagnostic XRay Major Componets Product
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Accidental Radiation Occurence
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Laser Light Show Variance Application
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Notice of Availability-Sample electronic Product
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Assembler Report
5678	Reporting and Recordkeeping for Electronic Products - General Requirements	Form and Instruction	Modified	Declaration of Imported Electronic Products

ICR Details

OMB Control No: 0910-0025	ICR Reference No: 200703-0910-007
Status: Historical Active	Previous ICR Reference No: 200310-0910-007
Agency/Subagency: HHS/FDA	Agency Tracking No:
Title: Reporting and Recordkeeping for Electronic Products - General Requirements
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/15/2007
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/14/2007
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2010	36 Months From Approved	05/31/2007
Responses	47,355	0	47,343
Time Burden (Hours)	342,889	0	324,957
Cost Burden (Dollars)	0	0	0

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Abstract: To protect the public from unnecessary exposure to radiation from electronic products, FDA must collect certain information from manufacturers and dealers/distributors about electronic products they sell or install.

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Authorizing Statute(s): US Code: 21 USC 360
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 64714	11/03/2006
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 8747	02/27/2007
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Reporting and Recordkeeping for Electronic Products - General Requirements	3632, 3633, 3634, 3635, 3636, 3637, 3638, 3639, 3640, 3641, 3642, 3643, 3644, 3645, 3646, 3647, 2877, 2579, 2767, 3147, 3649, 3626, 3627, 3628, 3629, 3630, 3631	Declaration of Imported Electronic Products ,   Assembler Report ,   Notice of Availability-Sample electronic Product ,   Laser Light Show Variance Application ,   Accidental Radiation Occurence ,   Diagnostic XRay Major Componets Product ,   Diagnostic XRay CT Report ,   General Annual Report ,   Abbreviated Report ,   Sunlamp Product Report ,   Sunlamp Annual Report ,   Laser Product Report ,   General Variance Request ,   TV Annual Report ,   Laser Light Show Nodification ,   Laser Light Show Annual Report ,   Laser Original equipment Manufacturer Report ,   Annual Report XRay Components and Systems ,   Cabinet XRay System Product Report ,   Laser Light Show Product Report ,   Cabinet XRay Annual Report ,   General Correspondence ,   Microwave Annual Report ,   Ultrasonic Therapy Product Report ,   Ultrasonic Therapy Annual Report ,   Mercury Vapor Lamp Product Report ,   Mercury Vapor Lamp Annual Report

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ICR Summary of Burden

table that charts list of burden

	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	47,355	47,343	0	0	12	0
Annual Time Burden (Hours)	342,889	324,957	0	0	17,932	0
Annual Cost Burden (Dollars)	0	0	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: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $2

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

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 03/14/2007

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