Information Collection

Tobacco Health Document Submission

IC 191698 under ICR 201710-0910-014 · OMB 0910-0654.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0654 can be found here:

Documents and Forms

Document Name Document Type
Form FDA Tobacco Health Document Submission Form and Instruction
FDA Tobacco Health Document Submission FDA-3743 2017.pdf Form and Instruction
Health documents guidance.pdf Tobacco Health Document Submission Final Guidance IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Tobacco Health Document Submission	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FDA	Tobacco Health Document Submission	FDA-3743 2017.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: 1

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 20 %

	Approved	Previously Approved
Annual Number of Responses for this IC	32	32
Annual IC Time Burden (Hours)	1,600	1,600
Annual IC Cost Burden (Dollars)	832	832

Documents for IC

Title	Document	Date Uploaded
Tobacco Health Document Submission Final Guidance	Health documents guidance.pdf	10/24/2017

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