User Fee Payment Refund Request --Form FDA 3913

Electronic User Fee Payment Form Requests

OMB: 0910-0805

IC ID: 218309

Information Collection (IC) Details

View Information Collection (IC)

User Fee Payment Refund Request --Form FDA 3913
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form Form FDA 3913 Refund Request Refund_Request_Form FDA 3913.pdf Yes Yes Fillable Fileable Signable

Health Consumer Health and Safety

 

474 0
   
Private Sector Businesses or other for-profits
 
   95 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 474 0 0 -1,183 0 1,657
Annual IC Time Burden (Hours) 190 0 0 -473 0 663
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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