Information Collection

Tobacco Amendment and General Correspondence

IC 225063 under ICR 201701-0910-004 · OMB 0910-0673.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0673 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FDA 3964 Tobacco Amendment and General Correspondence	Form and Instruction
FDA 3964 Tobacco Amendment and General Correspondence Report FDA-3964.pdf	Form and Instruction

IC Title:

Tobacco Amendment and General Correspondence

Agency IC Tracking Number:

CTP

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

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	FDA 3964	Tobacco Amendment and General Correspondence Report	FDA-3964.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 628

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	628	628
Annual IC Time Burden (Hours)	52	52
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.