Information Collection

Certification for citizen petitions 505(q)(H)

IC 196101 under ICR 201704-0910-003 · OMB 0910-0679.

Documents and Forms

Document Name Document Type
FINAL GUIDANCE 0679 3-18-14.pdf Other-Guidance

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Certification for citizen petitions 505(q)(H)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Guidance			FINAL GUIDANCE 0679 3-18-14.pdf		Yes	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 38	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	52	22	30
Annual IC Time Burden (Hours)	26	11	15
Annual IC Cost Burden (Dollars)	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.