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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

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.