Information Collection

List of Ingredients Added in the Manufacture of Smokeless Tobacco Products

IC 37761 under ICR 201207-0920-005 · OMB 0920-0338.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0338 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att 4a-1 SLT Ingredient Report.doc	Other-WORD
Att 4a-2 SLT Nicotine Report.doc	Other-WORD
Att 4b Reminder Notification.pdf Att 4b Reminder Notification	IC Document
Att 4c Reminder Notification.doc Att 4c Reminder Notification	IC Document
Att 6a Web Page_OSH Tob Ingred Rep.pdf Att 6a Web Page_OSH Tob Ingred Rep	IC Document
Att 6b Web Page_OSH Comp Smokeless Tob Hlth Edu Act.pdf Att 6b Web Page_OSH Comp Smokeless Tob Hlth Edu Act	IC Document

IC Title:

List of Ingredients Added in the Manufacture of Smokeless Tobacco Products

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 18 CFR 1905 15 CFR 4401

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
Other-WORD			Att 4a-1 SLT Ingredient Report.doc		Yes	Yes	Fillable Printable
Other-WORD			Att 4a-2 SLT Nicotine Report.doc		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 13

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
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	13	2	11
Annual IC Time Burden (Hours)	22,269	3,426	18,843
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att 4b Reminder Notification	Att 4b Reminder Notification.pdf	06/29/2012
Att 4c Reminder Notification	Att 4c Reminder Notification.doc	06/29/2012
Att 6a Web Page_OSH Tob Ingred Rep	Att 6a Web Page_OSH Tob Ingred Rep.pdf	06/29/2012
Att 6b Web Page_OSH Comp Smokeless Tob Hlth Edu Act	Att 6b Web Page_OSH Comp Smokeless Tob Hlth Edu Act.pdf	06/29/2012

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