Device Facility User Fee Cover Sheet (Form FDA 3601(a))

Medical Device User Fee Cover Sheet and Device Facility User Fee Cover Sheet — Form FDA 3601 and Form 3601(a)

Documents and Forms

Document Name Document Type
Form FDA 3601(a) Device Facility User Fee Cover Sheet (Form FDA 3601(a)) Form
FDA 3601(a) Device Facility User Fee 3601aFURLS_Coversheet.pdf Form

Information Collection (IC) Details

IC Title:	Device Facility User Fee Cover Sheet (Form FDA 3601(a))	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FDA 3601(a)	Device Facility User Fee	3601aFURLS_Coversheet.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 24,086	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	24,086	24,086
Annual IC Time Burden (Hours)	4,095	4,095
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.