Information Collection

Assurance of Compliance

IC 238746 under ICR 201906-0945-003 · OMB 0945-0008.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0945-0008 can be found here:

Documents and Forms

Document Name Document Type
Form 690 Assurance of Compliance Form
690 Assurance of Compliance Revised clean Form for 88.4 HHS-690Nov222019 - 11-26 rev.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Assurance of Compliance	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	690	Assurance of Compliance	Revised clean Form for 88.4 HHS-690Nov222019 - 11-26 rev.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500,290	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500,290	500,290
Annual IC Time Burden (Hours)	2,501,450	2,501,450
Annual IC Cost Burden (Dollars)	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.