Information Collection

Ingredient Report

IC 183310 under ICR 201102-0920-007 · OMB 0920-0210.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0210 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form no number Ingredient Report	Form and Instruction
no number Tobacco Ingredient Reporting Web Page Tobacco Ingredient Reporting Webpage.pdf	Form and Instruction
1 Recommended Ingredient Reporting Format-CSTHEA Attachment 4a Ingredient Report.doc	Form and Instruction
Attachment 3. Reminder Postcard.doc Attachment 3 - reminder postcard	IC Document
Attachment 4b. OSH Web Page on Act.pdf Attachment 4b - OSH web page	IC Document
Attachment 8. Request for Add Info.doc Attachment 8 - Request for Additional Information	IC Document
Attachment 5b OSH Web Page on Tobacco Ingredient Reporting.pdf Attachment 5b OSH Web Page on Tobacco Ingredient Reporting	IC Document
Attacthment 7a Guidelines to Control & Protect Documents that contain Privileged info.pdf Attacthment 7a Guidelines to Control & Protect Documents that contain Privileged info	IC Document

IC Title:

Ingredient Report

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 15 CFR 4401 18 CFR 1905

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	no number	Tobacco Ingredient Reporting Web Page	Tobacco Ingredient Reporting Webpage.pdf		No	No	Paper Only
Form and Instruction	1	Recommended Ingredient Reporting Format-CSTHEA	Attachment 4a Ingredient Report.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 143

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	143	143
Annual IC Time Burden (Hours)	930	930
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment 3 - reminder postcard	Attachment 3. Reminder Postcard.doc	12/12/2007
Attachment 4b - OSH web page	Attachment 4b. OSH Web Page on Act.pdf	12/12/2007
Attachment 8 - Request for Additional Information	Attachment 8. Request for Add Info.doc	12/12/2007
Attachment 5b OSH Web Page on Tobacco Ingredient Reporting	Attachment 5b OSH Web Page on Tobacco Ingredient Reporting.pdf	01/20/2011
Attacthment 7a Guidelines to Control & Protect Documents that contain Privileged info	Attacthment 7a Guidelines to Control & Protect Documents that contain Privileged info.pdf	01/20/2011

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