Information Collection

Annual submission of request for further review of dispute of user fee

IC 207254 under ICR 202104-0910-014 · OMB 0910-0749.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0749 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Section_1150_15_d.doc Section 1150_15_d	IC Document
Section_1150_15_d.doc Section 1150_15_d	IC Document

IC Title:

Annual submission of request for further review of dispute of user fee

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 21 CFR 1150.15

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

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3

Number of Respondents for Small Entity: 1

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	3	3
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Section 1150_15_d	Section_1150_15_d.doc	03/08/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.