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User Fee Payment Transfer Request--Form FDA 3914
Electronic User Fee Payment Form Requests
OMB: 0910-0805
IC ID: 218311
OMB.report
HHS/FDA
OMB 0910-0805
ICR 202403-0910-004
IC 218311
( )
Documents and Forms
Document Name
Document Type
Form Form FDA 3914
User Fee Payment Transfer Request--Form FDA 3914
Form
Form FDA 3914 Transfer Request
0805_FORM FDA 3914.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
User Fee Payment Transfer Request--Form FDA 3914
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
Form FDA 3914
Transfer Request
0805_FORM FDA 3914.pdf
Yes
Yes
Fillable Fileable Signable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
86
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
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
86
0
0
-108
0
194
Annual IC Time Burden (Hours)
22
0
0
-27
0
49
Annual IC Cost Burden (Dollars)
0
0
0
0
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.