Information Collection

FY 2012 MDUFMA Small Business Qualification Certification (Form FDA 3602)

IC 6222 under ICR 201301-0910-010 · OMB 0910-0508.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0508 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3602 FY 2012 MDUFMA Small Business Qualification Certification (Form FDA 3602)	Form and Instruction
3602 Medical Device User Fee Guidance form 3602.pdf	Form and Instruction

IC Title:

FY 2012 MDUFMA Small Business Qualification Certification (Form FDA 3602)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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	3602	Medical Device User Fee	Guidance form 3602.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,100

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	5,100	1,529	3,571
Annual IC Time Burden (Hours)	5,100	1,529	3,571
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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