Information Collection

Self-certification

IC 44919 under ICR 200908-1117-006 · OMB 1117-0046.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1117-0046 can be found here:

Documents and Forms

Document Name Document Type
Form DEA Form 597 Self-certification Form and Instruction
DEA Form 597 CMEA Self-Certification 0046_CMEA Self Cert App 2009-6-30.doc www.DEAdiversion.usdoj.gov Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Self-certification	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 21 CFR 1314

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DEA Form 597	CMEA Self-Certification	0046_CMEA Self Cert App 2009-6-30.doc	www.DEAdiversion.usdoj.gov	Yes	Yes	Fillable Printable

Line of Business: Law Enforcement

Subfunction: Substance Control

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 64,000	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	64,000	-25,000	89,000
Annual IC Time Burden (Hours)	16,000	-28,500	44,500
Annual IC Cost Burden (Dollars)	941,500	-1,403,500	2,345,000

Documents for IC

Title	Document	Date Uploaded
No associated records found

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