Information Collection

Reporting and Recordkeeping

IC 206693 under ICR 201803-0910-006 · OMB 0910-0741.

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Information Collection (IC) Details

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IC Title:	Reporting and Recordkeeping	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 21 CFR 807.87(j) 21 CFR 812.27(b)(4) 21 CFR 812.28(c) 21 CFR 812.28(b) 21 CFR 814.20 21 CFR 814.104 21 CFR 812.28(d) 21 CFR 812.140 21 CFR 812.28(a)(1)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,010	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	2,010	2,010
Annual IC Time Burden (Hours)	17,780	17,780
Annual IC Cost Burden (Dollars)	0	0

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