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Expanded Individual Patient Access Application Submissions
Individual Patient Expanded Access Applications
OMB: 0910-0814
IC ID: 220651
OMB.report
HHS/FDA
OMB 0910-0814
ICR 201903-0910-003
IC 220651
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0814 can be found here:
2023-09-07 - Revision of a currently approved collection
2022-04-29 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
0814 Exp Access GFI Updated Oct 2017.pdf
Other-Agency Guidance
Form FDA 3926 Instructional Supplement.pdf
Instruction
Form FDA 3926 Individual Patient Expanded Access Investigational New D
Form FDA 3926 Expanded Access.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Expanded Individual Patient Access Application Submissions
Agency IC Tracking Number:
CDER
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
21 CFR 312.300-312.320
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Agency Guidance
0814 Exp Access GFI Updated Oct 2017.pdf
Yes
Yes
Fillable Fileable
Form
Form FDA 3926
Individual Patient Expanded Access Investigational New Drug Application
Form FDA 3926 Expanded Access.pdf
Yes
Yes
Fillable Fileable
Instruction
Form FDA 3926 Instructional Supplement.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
790
Number of Respondents for Small Entity:
790
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
2,394
0
0
0
0
2,394
Annual IC Time Burden (Hours)
1,796
0
0
0
0
1,796
Annual IC Cost Burden (Dollars)
0
0
0
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.