Information Collection

Ingredient Report

IC 183310 under ICR 202203-0920-015 · OMB 0920-0210.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0210 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0210 Ingredient Report	Form and Instruction
0920-0210 Recommended Cigarette Ingredient Reporting Format - FCLA Recommended Cigarette Ingredient Reporting Format for OMB 2019.doc	Form and Instruction
0920-0210 Recommended Cigarette Ingredient Reporting Format - FCLA Recommended Cigarette Ingredient Reporting Format for OMB 2019.doc	Form and Instruction

IC Title:

Ingredient Report

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 18 CFR 1905 15 CFR 4401

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
Form and Instruction	0920-0210	Recommended Cigarette Ingredient Reporting Format - FCLAA	Recommended Cigarette Ingredient Reporting Format for OMB 2019.doc	NA	No		Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 55

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	55	55
Annual IC Time Burden (Hours)	358	358
Annual IC Cost Burden (Dollars)	20,496	20,496

Documents for IC

table that charts IC Documents
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.