Information Collection

Smokeless Tobacco Nicotine and Ingredient Report

IC 37761 under ICR 201901-0920-001 · OMB 0920-0338.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0338 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0338 Smokeless Tobacco Nicotine and Ingredient Report	Form and Instruction
0920-0338 Ingredient Reporting Format 0920 0338 Att 4a Smokeless Tobacco Ing Report Format Final.pdf	Form and Instruction
0920-0338 Nicotine Report Format 0920 0338 Att 4b Smokeless Tobacco Nicotine Report Format Final.pdf	Form and Instruction

IC Title:

Smokeless Tobacco Nicotine and Ingredient Report

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 15 CFR 4401 18 CFR 1905

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	0920-0338	Ingredient Reporting Format	0920 0338 Att 4a Smokeless Tobacco Ing Report Format Final.pdf	na	No		Paper Only
Form and Instruction	0920-0338	Nicotine Report Format	0920 0338 Att 4b Smokeless Tobacco Nicotine Report Format Final.pdf	na	No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 11

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
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	11	11
Annual IC Time Burden (Hours)	18,843	18,843
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.