Information Collection

Ingredient Report

IC 183310 under ICR 201301-0920-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Attachment 4a Ingredient Report.pdf	Other-WORD
Attachment 8. Request for Add Info.doc Attachment 8 - Request for Additional Information	IC Document
Attachment 4b Reminder Notification.pdf Attachment 4b Reminder Notification	IC Document
Attachment 4c Request for Additional Information.pdf Attachment 4c Request for Additional Information	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: 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			Attachment 4a Ingredient Report.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 77

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	77	77
Annual IC Time Burden (Hours)	501	501
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment 8 - Request for Additional Information	Attachment 8. Request for Add Info.doc	12/12/2007
Attachment 4b Reminder Notification	Attachment 4b Reminder Notification.pdf	12/28/2012
Attachment 4c Request for Additional Information	Attachment 4c Request for Additional Information.pdf	12/28/2012

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