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Drug Origin Statement
Prescription Drug Marketing Act of 1987; Policies, Requirements, and Administrative Procedures
OMB: 0910-0435
IC ID: 190512
OMB.report
HHS/FDA
OMB 0910-0435
ICR 201503-0910-001
IC 190512
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0435 can be found here:
2024-06-06 - Extension without change of a currently approved collection
2021-06-25 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Drug Origin Statement
Agency IC Tracking Number:
CDER
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
21 CFR 203.50(b)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
125
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
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
12,500
0
0
0
0
12,500
Annual IC Time Burden (Hours)
6,250
0
0
0
0
6,250
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.