Information Collection Request

Medical Device User Fee Cover Sheet and Device Facility User Fee Cover Sheet — Form FDA 3601 and Form 3601(a)

ICR 202107-0910-002 · OMB 0910-0511 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form FDA 3601 Medical Device User Fee Cover Sheet (Form FDA 3601) Form Modified Repair queued
Form FDA 3601(a) Device Facility User Fee Cover Sheet (Form FDA 3601(a)) Form New Repair queued
0511_Supporting Statement_2021.docx Supporting Statement A Uploaded 2021-08-16 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
6227 Medical Device User Fee Cover Sheet (Form FDA 3601) Form Modified
248796 Device Facility User Fee Cover Sheet (Form FDA 3601(a)) Form New

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 08/31/2022
30,268 6,379
5,950 1,914
0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Device Facility User Fee Cover Sheet (Form FDA 3601(a)) FDA 3601(a) Device Facility User Fee
Medical Device User Fee Cover Sheet (Form FDA 3601) FDA 3601 Medical Device User Fee Cover Sheet

table that charts list of burden
  Total Request 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 30,268 6,379 0 0 23,889 0
Annual Time Burden (Hours) 5,950 1,914 0 0 4,036 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No