OMB
.report
Search
600.80(c)(2)
Adverse Experience Reporting for Licensed Biological Product; and General Records
OMB: 0910-0308
IC ID: 185787
OMB.report
HHS/FDA
OMB 0910-0308
ICR 201410-0910-016
IC 185787
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0308 can be found here:
2024-04-26 - Extension without change of a currently approved collection
2023-03-20 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 3500A
600.80(c)(2)
Form
3500A MEDWATCH
FORM FDA 3500A MEDWATCH.pdf
Form
VAERS-1 Vaccine Adverse Event Reporting System
VAERS-1 FORM.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
600.80(c)(2)
Agency IC Tracking Number:
CBER
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
21 CFR 600.80(c)(2)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
3500A
MEDWATCH
FORM FDA 3500A MEDWATCH.pdf
Yes
Yes
Fillable Fileable Signable
Form and Instruction
VAERS-1
Vaccine Adverse Event Reporting System
VAERS-1 FORM.pdf
Yes
Yes
Fillable Fileable Signable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
131
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
132,668
0
0
75,368
0
57,300
Annual IC Time Burden (Hours)
3,714,704
0
0
2,110,304
0
1,604,400
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.