Potential Tobacco Product Violations Reporting

Potential Tobacco Product Violations Reporting Form

OMB: 0910-0716

IC ID: 201526

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Information Collection (IC) Details

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Potential Tobacco Product Violations Reporting
No Modified

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction FDA 3779 Potential Tobacco Product Violations Report 0716_Form 3779_2023.pdf Yes Yes Fillable Fileable

Health Consumer Health and Safety


3,000 200
Individuals or Households
   99 %

  Requested 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 6,000 0 0 630 0 5,370
Annual IC Time Burden (Hours) 1,500 0 0 157 0 1,343
Annual IC Cost Burden (Dollars) 0 0 -24 0 0 24

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