Information Collection

312.32(c)(1)(iv)

IC 194533 under ICR 201009-0910-004 · OMB 0910-0672.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0672 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	312.32(c)(1)(iv)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 21 CFR 312.32(c)(1)(iv)

Information Collection Instruments:

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

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 25 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	120	120
Annual IC Cost Burden (Dollars)	750	750

Documents for IC

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