Tobacco Health Document Submission

⚠️ Notice: This information collection may be referencing outdated material.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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	32	0	32
Annual IC Time Burden (Hours)	1,600	0	1,600
Annual IC Cost Burden (Dollars)	902	70	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.