Dissolvable Tobacco Products Information Request

Information Request Regarding Dissolvable Tobacco Products

Documents and Forms

Document Name Document Type
Dissolvable 904(b) Request Letter-022511.doc Instruction
Dissolvables 30-day draft.doc Dissolvable Letter Request 30 Day Federal Register Notice IC Document

Information Collection (IC) Details

IC Title:	Dissolvable Tobacco Products Information Request	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Dissolvable 904(b) Request Letter-022511.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 120	Number of Respondents for Small Entity: 113

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

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	120	120
Annual IC Time Burden (Hours)	24,220	24,220
Annual IC Cost Burden (Dollars)	924	924

Documents for IC

Title	Document	Date Uploaded
Dissolvable Letter Request 30 Day Federal Register Notice	Dissolvables 30-day draft.doc	02/25/2011

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