Information Collection

Request for Determination of Eligibility Criteria

IC 206353 under ICR 201907-0910-008 · OMB 0910-0661.

Documents and Forms

Document Name Document Type
0661 guidance.pdf Other-Guidance; Humanitarian Device

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Determination of Eligibility Criteria	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Guidance; Humanitarian Device Exemption (HDE) Regulation: Questions and Answers			0661 guidance.pdf		Yes	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1	-1	2
Annual IC Time Burden (Hours)	10	-10	20
Annual IC Cost Burden (Dollars)	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.