Information Collection

Consumer Compliant Monitoring System

IC 2857 under ICR 202402-0583-001 · OMB 0583-0133.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
eCCF screenshots document- English.docx	Other-web form
eCCF screenshots document- English.docx	Other-web form
eCCF screenshots document - Spanish v2.docx	Other-web form - Spanish
eCCF screenshots document - Spanish v2.docx	Other-web form - Spanish

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

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
Other-web form					Yes	Yes	Fillable Fileable
Other-web form - Spanish					Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,000

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	Previously Approved
Annual Number of Responses for this IC	3,000	3,000
Annual IC Time Burden (Hours)	750	750
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.

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