Tobacco Health Document Submission

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0654 can be found here:

Documents and Forms

Document Name Document Type
Form 3743 Tobacco Health Document Submission Form and Instruction
3743 Tobacco Health Document Submission FDA Form 3743.pdf Form and Instruction
TB Health Doc Submission Guidance.pdf Tobacco Health Document Submission Final Guidance IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Tobacco Health Document Submission	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Form and Instruction	3743	Tobacco Health Document Submission	FDA Form 3743.pdf		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: 4	Number of Respondents for Small Entity: 1

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

Percentage of Respondents Reporting Electronically: 20 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	8	-792	800
Annual IC Time Burden (Hours)	400	-7,600	8,000
Annual IC Cost Burden (Dollars)	208	208	0

Documents for IC

Title	Document	Date Uploaded
Tobacco Health Document Submission Final Guidance	TB Health Doc Submission Guidance.pdf	08/06/2013

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