Information Collection

Documenting transaction information

IC 218214 under ICR 202407-0910-009 · OMB 0910-0806.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3911 Documenting transaction information	Form
Form 3911 Drug Notification Documenting transaction information	Form
3911 Drug Notification FDA FORM 3911.pdf	Form
3911 Drug Notification FDA FORM 3911.pdf	Form

IC Title:

Agency IC Tracking Number:

CDER

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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	3911				Yes	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 70,000

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	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	70,000,000,000	69,999,999,500	500
Annual IC Time Burden (Hours)	119,000	118,500	500
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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