Information Collection

Pre-letter, invitation, reminder, survey

IC 263599 under ICR 202311-0910-009 · OMB 0910-0929.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0929 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment A Quant Claims Survey.docx	Other-Survey
Appendix B Quant Claims Pre-Notification Letter.docx	Other-Pre-notification letter
Appendix C Quant Claims Invitation Letter.docx	Other-Invitation letter
Appendix D Quant Claims Reminder Postcard.docx	Other-Reminder
Appendix E Quant Claims Final letter.docx	Other-Final letter
Appendix F Quant Claims Official FDA Announcement for Survey.docx	Other-FDA announcement of survey
Appendix G Quant Claims Post-paid Incentive Letter.docx	Other-Incentive letter
Appendix A. Survey.docx	Other-Survey
Appendix B. Pre-Notification Letter.docx	Other-Pre-notification letter
Appendix C. Invitation Letter.docx	Other-Invitation letter
Appendix D. Reminder Postcard.docx	Other-Reminder postcard
Appendix E. Final letter.docx	Other-Final letter
Appendix F. Official FDA Announcement for Survey.docx	Other-FDA announcement of survey
Appendix G. Post-Paid Incentive Letter.docx	Other-Post incentive letter

IC Title:

Pre-letter, invitation, reminder, survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey	Appendix A. Survey.docx	Yes	Yes	Fillable Fileable
Other-Pre-notification letter	Appendix B. Pre-Notification Letter.docx	Yes	Yes	Printable Only
Other-Invitation letter	Appendix C. Invitation Letter.docx	Yes	Yes	Fillable Fileable
Other-Reminder postcard	Appendix D. Reminder Postcard.docx	Yes	No	Printable Only
Other-Final letter	Appendix E. Final letter.docx	Yes	Yes	Fillable Fileable
Other-FDA announcement of survey	Appendix F. Official FDA Announcement for Survey.docx	Yes	No	Printable Only
Other-Post incentive letter	Appendix G. Post-Paid Incentive Letter.docx	Yes	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,993

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,993	2,993
Annual IC Time Burden (Hours)	1,094	1,094
Annual IC Cost Burden (Dollars)	0	0

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.