Information Collection

Requests to Receive Prescribing Information by Fax, Email, or Mail When Requested

IC 216752 under ICR 201412-0910-014 · OMB 0910-0794.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

Requests to Receive Prescribing Information by Fax, Email, or Mail When Requested

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 21 CFR 201.100(c)(5) 21 CFR 201.100(g)

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

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 129,090

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	129,090	129,090
Annual IC Time Burden (Hours)	32,273	32,273
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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