Information Collection

Submission of User Fee Dispute

IC 207253 under ICR 201603-0910-014 · OMB 0910-0749.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0749 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Section_1150_15_a.doc Section 1150_15_a	IC Document

IC Title:

Submission of User Fee Dispute

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 21 CFR 1150.15(a)

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: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 9

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Section 1150_15_a	Section_1150_15_a.doc	03/08/2014

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