Information Collection

Reporting- Foreign Establishments Response to Questions By FDA Regarding Products Offered for Import into The U.S. Response is Communicated on Behalf of Foreign Establishments United States Agent

IC 193011 under ICR 201005-0910-010 · OMB 0910-0625.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0625 can be found here:

Documents and Forms

Document Name Document Type
Form 3673 Reporting- Foreign Establishments Response to Questions By FDA Regarding Products Offered for Import into The U.S. Response is Communicated on Behalf of Foreign Establishments United States Agent Form and Instruction
3673 Device Registration & Listing Module Form FDA 3673 Device Regs & Liasting Module.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Reporting- Foreign Establishments Response to Questions By FDA Regarding Products Offered for Import into The U.S. Response is Communicated on Behalf of Foreign Establishments United States Agent	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 21 CFR 807.40 (b)(2)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3673	Device Registration & Listing Module	Form FDA 3673 Device Regs & Liasting Module.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 99 %

	Requested	Program Change Due to New Statute
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

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.