Information Collection

21 CFR 170.106 (Category A)

IC 37671 under ICR 201602-0910-004 · OMB 0910-0495.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0495 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form FDA 3479 21 CFR 170.106 (Category A)	Form and Instruction
Form FDA 3479 NOTIFICATION FOR A FOOD CONTACT 0495 - Form FDA 3479.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 21 CFR 170.106

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 FDA 3479	NOTIFICATION FOR A FOOD CONTACT	0495 - Form FDA 3479.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	20	15	5
Annual IC Time Burden (Hours)	40	30	10
Annual IC Cost Burden (Dollars)	0	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.