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314.80(g)(2)
Postmarketing Safety Reports for Human Drug and Biological Products: Electronic Submission Requirements - Final Rule
OMB: 0910-0770
IC ID: 211823
OMB.report
HHS/FDA
OMB 0910-0770
ICR 201411-0910-004
IC 211823
( )
Documents and Forms
Document Name
Document Type
Form 3500A
314.80(g)(2)
Form
3500A MedWatch
FORM FDA 3500A.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
314.80(g)(2)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Mandatory
CFR Citation:
21 CFR 314.80(g)(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.pdf
Yes
Yes
Fillable Fileable Signable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
5
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
5
0
5
0
0
0
Annual IC Time Burden (Hours)
5
0
5
0
0
0
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.