Information Collection

Biological products Reporting

IC 5877 under ICR 202403-0910-011 · OMB 0910-0308.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3500A Biological products Reporting	Form
Form 3500A MEDWATCH Biological products Reporting	Form
Form VAERS-1 Vaccine Adverse Event Reporting System Biological products Reporting	Form and Instruction
3500A MEDWATCH FORM FDA 3500A MEDWATCH.pdf	Form
3500A MEDWATCH FORM FDA 3500A MEDWATCH.pdf	Form
VAERS-1 Vaccine Adverse Event Reporting System VAERS-1 FORM.pdf	Form and Instruction
VAERS-1 Vaccine Adverse Event Reporting System VAERS-1 FORM.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 21 CFR 600.80 21 CFR 610.18

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
Form	3500A				Yes	Yes	Fillable Fileable Signable
Form and Instruction	VAERS-1				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: 109

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	586,849	232,363	354,486
Annual IC Time Burden (Hours)	8,514,595	3,184,919	5,329,676
Annual IC Cost Burden (Dollars)	0	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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