Information Collection

Monthly certified copies

IC 207251 under ICR 201407-0910-010 · OMB 0910-0749.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0749 can be found here:

Documents and Forms

Document Name Document Type
Section_1150_5_b_3.doc Section 1150_5_b_3 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Monthly certified copies	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 21 CFR 1150.5(b)(3)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 180

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

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,400	2,400
Annual IC Time Burden (Hours)	2,400	2,400
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Section 1150_5_b_3	Section_1150_5_b_3.doc	03/08/2014

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