Information Collection

Common Formats

IC 186799 under ICR 201411-0935-001 · OMB 0935-0143.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0143 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form #7 Common Formats	Form and Instruction
Form #7 Common Formats Supplemental Details Attachment.K.Common Formats Supplemental Details.2014.fine.2.docx	Form and Instruction
Attachment.K.Common Formats Supplemental Details.2014.fine.2.docx Attachment K: Common Formats Details	IC Document

IC Title:

Common Formats

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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
Form and Instruction	Form #7	Common Formats Supplemental Details	Attachment.K.Common Formats Supplemental Details.2014.fine.2.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	1,000	250	750
Annual IC Time Burden (Hours)	100,000	25,000	75,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment K: Common Formats Details	Attachment.K.Common Formats Supplemental Details.2014.fine.2.docx	11/12/2014

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