Certification--54.4(a)(1) and (a)(2)--Form FDA 3454

Financial Disclosure by Clinical Investigators

OMB: 0910-0396

IC ID: 6057

Information Collection (IC) Details

View Information Collection (IC)

Certification--54.4(a)(1) and (a)(2)--Form FDA 3454
 
No Modified
 
Mandatory
 
21 CFR 301

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 3454 FDA Form 3454 FDA 3454 exp 12-31-15.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

1,000 0
   
Individuals or Households
 
   10 %

  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 1,000 0 0 98 0 902
Annual IC Time Burden (Hours) 1,000 0 0 98 0 902
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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