Information Collection

FDA Export Certification Inquiry

IC 269965 under ICR 202404-0910-006 · OMB 0910-0793.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FDA 5077 FDA Export Certification Inquiry	Form and Instruction
FDA 5077 FDA Export Certification Inquiry Form FDA 5077 ECITS Webform-040924.pdf	Form and Instruction
FDA 5077 FDA Export Certification Inquiry Form FDA 5077 ECITS Webform-040924.pdf	Form and Instruction

IC Title:

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	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FDA 5077	FDA Export Certification Inquiry	Form FDA 5077 ECITS Webform-040924.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 520

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	9,360	9,360
Annual IC Time Burden (Hours)	2,340	2,340
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.