Voluntary National Retail Food Regulatory Program Standards

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 3958 FDA National Registry Report	Form and Instruction	Removed	Available
Form 3958 Submission of Form FDA 3958	Form and Instruction	Removed	Repair queued
Form FDA 3958 Voluntary National Retail Food Regulatory Program Standards FDA National Registry Report	Form and Instruction	Modified	Available
Form FDA 5019 Standardized Food Safety Inspection Officer Nomination Form	Form and Instruction	Modified	Available
Form FDA 5018 Standardized Retail Food Safety Inspection Officer Annual Maintenance Form	Form and Instruction	Modified	Available
Form FDA 5017 Standardized Retail Food Safety Inspection Officer Waiver of Annual Maintenance Requirement Form	Form and Instruction	Modified	Available
Form FDA 5017 Voluntary National Retail Standards: Worksheets and assessments	Form and Instruction	Modified	Repair queued
0621 Voluntary Food Retail Stds SSA 2023 REV.docx	Supporting Statement A	Uploaded 2023-09-20	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
197119	Reporting: Requests for Documentation of Successful Completion of Staff Training	Other-Program Standards	Removed
183429	Submission of Form FDA 3958	Form and Instruction	Removed	FDA National Registry Report
183429	Submission of Form FDA 3958	Form and Instruction	Removed
183429	Submission of Form FDA 3958	Other-Program Standards	Removed
183428	Voluntary National Retail Standards: Worksheets and assessments	Form and Instruction	Modified	Voluntary National Retail Food Regulatory Program Standards FDA National Registry Report
183428	Voluntary National Retail Standards: Worksheets and assessments	Form and Instruction	Modified	Standardized Food Safety Inspection Officer Nomination Form
183428	Voluntary National Retail Standards: Worksheets and assessments	Form and Instruction	Modified	Standardized Retail Food Safety Inspection Officer Annual Maintenance Form
183428	Voluntary National Retail Standards: Worksheets and assessments	Form and Instruction	Modified	Standardized Retail Food Safety Inspection Officer Waiver of Annual Maintenance Requirement Form
183428	Voluntary National Retail Standards: Worksheets and assessments	Form and Instruction	Modified
183428	Voluntary National Retail Standards: Worksheets and assessments	Other-Program Standards	Modified

ICR Details

OMB Control No: 0910-0621	ICR Reference No: 202306-0910-002
Status: Active	Previous ICR Reference No: 202008-0910-001
Agency/Subagency: HHS/FDA	Agency Tracking No: CFSAN
Title: Voluntary National Retail Food Regulatory Program Standards
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/24/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/20/2023
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2026	36 Months From Approved	10/31/2023
Responses	4,154	0	2,500
Time Burden (Hours)	283,122	0	47,345
Cost Burden (Dollars)	0	0	0

---

Abstract: This information collection supports implementation of FDA’s Voluntary National Retail Food Regulatory Program Standards (the Retail Program Standards), which play a critical role in an integrated food safety system. FDA works cooperatively with state, local, territorial and tribal partners using a risk-based approach to leverage its limited resources to help ensure the safety and security of the food supply at the retail level. Respondents to the collections of information are regulatory food officials working in this capacity.

---

Authorizing Statute(s): US Code: 42 USC 243 Name of Law: PHS Act
   US Code: 21 USC 393(b)(4) Name of Law: FFDCA
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 43272	06/30/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 64440	09/19/2023
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Reporting: Requests for Documentation of Successful Completion of Staff Training
Submission of Form FDA 3958	3958	FDA National Registry Report
Voluntary National Retail Standards: Worksheets and assessments	FDA 5017, FDA 5018, FDA 5019, FDA 3958	Standardized Retail Food Safety Inspection Officer Waiver of Annual Maintenance Requirement Form ,   Standardized Retail Food Safety Inspection Officer Annual Maintenance Form ,   Standardized Food Safety Inspection Officer Nomination Form ,   Voluntary National Retail Food Regulatory Program Standards FDA National Registry Report

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	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	4,154	2,500	0	0	1,654	0
Annual Time Burden (Hours)	283,122	47,345	0	0	235,777	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: We have adjusted our estimate upward to reflect increased participation in the program. We are also introducing new and revised collection instruments.

---

Annual Cost to Federal Government: $27,908

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/20/2023

---