Export Certificates for FDA Regulated Products

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FDA 3613c Supplementary Information Non-Clinical Research Use Only Certificate	Form and Instruction	Modified	Available
Form FDA 3613b Supplementary Information Certificate of a Pharmaceutical Product	Form and Instruction	Modified	Available
Form FDA 3613a Supplementary Information Certificate of Exportability Requests	Form and Instruction	Modified	Available
Form FDA 3613 Supplementary Information Certificate to Foreign Government Requests	Form and Instruction	Modified	Available
Form FDA 3613 CBER Export Certificate (FDA 3613, 3613b, 3613c)	Form and Instruction	Modified	Repair queued
Form FDA 3613f REQUEST FOR CERTIFICATE OF A PHARMACEUTICAL PRODUCT FOR CDER PRODUCTS	Form and Instruction	Modified	Available
Form FDA 3613f CDER Export Certificate (FDA 3613f)	Form and Instruction	Modified	Repair queued
Form FDA 3613 Request for Certificate Supplementary Information	Form and Instruction	Modified	Available
Form FDA 3613b SUPPLEMENTARY INFORMATION CERTIFICATE OF A PHARMACEUTICAL PRODUCT	Form and Instruction	Modified	Available
Form FDA 3613a SUPPLEMENTARY INFORMATION CERTIFICATE OF EXPORTABILITY REQUESTS	Form and Instruction	Modified	Available
Form FDA 3613 SUPPLEMENTARY INFORMATION CERTIFICATE TO FOREIGN GOVERNMENT REQUESTS	Form and Instruction	Modified	Available
Form FDA 3613 CVM Export Certificate (FDA 3613, 3613b)	Form and Instruction	Modified	Repair queued
Form FDA 3613g Request for Certificate for Device not Exported from the United States	Form and Instruction	Modified	Available
Form FDA 3613c Supplementary Information Non-Clinical Research Use Only Certificate	Form and Instruction	Modified	Available
Form FDA 3613c CDRH Export Certificate (FDA 3613, 3613a, 3613c)	Form and Instruction	Modified	Repair queued
Form FDA 3613a Supplementary Information Certificate of Exportability Requests	Form and Instruction	Modified	Repair queued
Form FDA 3613 Supplementary Information Certificate to Foreign Government Requests	Form and Instruction	Modified	Available
0498 Export Certs SSA REV 2021.docx	Supporting Statement A	Uploaded 2021-03-03	Repair queued
0498 Emergency Revision Request SEP 2020.docx	Supplementary Document	Uploaded 2020-09-16	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
6208	CBER Export Certificate (FDA 3613, 3613b, 3613c)	Form and Instruction	Modified	Supplementary Information Non-Clinical Research Use Only Certificate
6208	CBER Export Certificate (FDA 3613, 3613b, 3613c)	Form and Instruction	Modified	Supplementary Information Certificate of a Pharmaceutical Product
6208	CBER Export Certificate (FDA 3613, 3613b, 3613c)	Form and Instruction	Modified	Supplementary Information Certificate of Exportability Requests
6208	CBER Export Certificate (FDA 3613, 3613b, 3613c)	Form and Instruction	Modified	Supplementary Information Certificate to Foreign Government Requests
6208	CBER Export Certificate (FDA 3613, 3613b, 3613c)	Form and Instruction	Modified
217014	CDER Export Certificate (FDA 3613f)	Form and Instruction	Modified	REQUEST FOR CERTIFICATE OF A PHARMACEUTICAL PRODUCT FOR CDER PRODUCTS
217014	CDER Export Certificate (FDA 3613f)	Form and Instruction	Modified
217014	CDER Export Certificate (FDA 3613f)	Other-Screenshots of electronic submission of API Drug	Modified
188597	CVM Export Certificate (FDA 3613, 3613b)	Form and Instruction	Modified	Request for Certificate Supplementary Information
188597	CVM Export Certificate (FDA 3613, 3613b)	Form and Instruction	Modified	SUPPLEMENTARY INFORMATION CERTIFICATE OF A PHARMACEUTICAL PRODUCT
188597	CVM Export Certificate (FDA 3613, 3613b)	Form and Instruction	Modified	SUPPLEMENTARY INFORMATION CERTIFICATE OF EXPORTABILITY REQUESTS
188597	CVM Export Certificate (FDA 3613, 3613b)	Form and Instruction	Modified	SUPPLEMENTARY INFORMATION CERTIFICATE TO FOREIGN GOVERNMENT REQUESTS
188597	CVM Export Certificate (FDA 3613, 3613b)	Form and Instruction	Modified
188596	CDRH Export Certificate (FDA 3613, 3613a, 3613c)	Form and Instruction	Modified	Request for Certificate for Device not Exported from the United States
188596	CDRH Export Certificate (FDA 3613, 3613a, 3613c)	Form and Instruction	Modified	Supplementary Information Non-Clinical Research Use Only Certificate
188596	CDRH Export Certificate (FDA 3613, 3613a, 3613c)	Form and Instruction	Modified
188596	CDRH Export Certificate (FDA 3613, 3613a, 3613c)	Form and Instruction	Modified	Supplementary Information Certificate of Exportability Requests
188596	CDRH Export Certificate (FDA 3613, 3613a, 3613c)	Form and Instruction	Modified	Supplementary Information Certificate to Foreign Government Requests

ICR Details

OMB Control No: 0910-0498	ICR Reference No: 202101-0910-012
Status: Historical Active	Previous ICR Reference No: 202009-0910-006
Agency/Subagency: HHS/FDA	Agency Tracking No: OC
Title: Export Certificates for FDA Regulated Products
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/14/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/03/2021
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2024	36 Months From Approved	04/30/2021
Responses	19,431	0	19,431
Time Burden (Hours)	30,606	0	30,606
Cost Burden (Dollars)	3,400,425	0	3,400,425

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Abstract: This information collection supports FDA's export certificate program established under authority of sections 801(e)(4) and 802 of the Federal, Food, Drug, and Cosmetic Act. Respondents to the collection are those seeking to obtain export certificates for FDA-regulated products. We have developed associated forms, and fees not to exceed $175 per certificate may apply.

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Authorizing Statute(s): PL: Pub.L. 116 - 136 3856 Name of Law: CARES Act
   US Code: 21 USC 381; 382 Name of Law: FFDCA; Imports/Exports; Exports of Unapproved Products
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 83091	12/21/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 83091	12/21/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
CBER Export Certificate (FDA 3613, 3613b, 3613c)	FDA 3613b, FDA 3613, FDA 3613c, FDA 3613a	Supplementary Information Certificate to Foreign Government Requests ,   Supplementary Information Certificate of Exportability Requests ,   Supplementary Information Certificate of a Pharmaceutical Product ,   Supplementary Information Non-Clinical Research Use Only Certificate
CDER Export Certificate (FDA 3613f)	FDA 3613f	REQUEST FOR CERTIFICATE OF A PHARMACEUTICAL PRODUCT FOR CDER PRODUCTS
CDRH Export Certificate (FDA 3613, 3613a, 3613c)	FDA 3613, FDA 3613a, FDA 3613g, FDA 3613c	Supplementary Information Certificate to Foreign Government Requests ,   Supplementary Information Certificate of Exportability Requests ,   Supplementary Information Non-Clinical Research Use Only Certificate ,   Request for Certificate for Device not Exported from the United States
CVM Export Certificate (FDA 3613, 3613b)	FDA 3613, FDA 3613a, FDA 3613, FDA 3613b	SUPPLEMENTARY INFORMATION CERTIFICATE TO FOREIGN GOVERNMENT REQUESTS ,   SUPPLEMENTARY INFORMATION CERTIFICATE OF EXPORTABILITY REQUESTS ,   SUPPLEMENTARY INFORMATION CERTIFICATE OF A PHARMACEUTICAL PRODUCT ,   Request for Certificate Supplementary Information

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	19,431	19,431	0	0	0	0
Annual Time Burden (Hours)	30,606	30,606	0	0	0	0
Annual Cost Burden (Dollars)	3,400,425	3,400,425	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Yes

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/03/2021

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