Information Collection

Request for Medical Product Safety Network (MedSun) Qualitative Feedback Generic Clearance about Newsletter Services

IC 202329 under ICR 201105-0910-006 · OMB 0910-0697.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0697 can be found here:

Documents and Forms

Document Name Document Type
APPENDIX A 4.23 .docx Other-Survey Appendix A
OMB Justification Memo MedSun1.doc OMB Justification Memo MedSun IC Document
Surveymonkey screens.pdf Surveymonkey Screenshots IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Medical Product Safety Network (MedSun) Qualitative Feedback Generic Clearance about Newsletter Services	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey Appendix A			APPENDIX A 4.23 .docx		Yes	Yes	Fillable Fileable Signable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,200	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	1,200	0	0	0	0	0
Annual IC Time Burden (Hours)	300	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Justification Memo MedSun	OMB Justification Memo MedSun1.doc	05/16/2012
Surveymonkey Screenshots	Surveymonkey screens.pdf	05/16/2012

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