Information Collection

Non-Applicants (Providing Statement that Material is Non-Infectious)

IC 269439 under ICR 202407-0920-001 · OMB 0920-0199.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Non-Applicants (Providing Statement that Material is Non-Infectious)	Form and Instruction
Importer Certification Statement Attachment 4d - Importer Certification Statement_10.30.23.docx	Form and Instruction
Importer Certification Statement Attachment 4d - Importer Certification Statement_10.30.23.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 71

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	n/a	Importer Certification Statement	Attachment 4d - Importer Certification Statement_10.30.23.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Electronic Import Permit Program

FR Citation: 85 FR 167

Number of Respondents: 5,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	5,000	5,000
Annual IC Time Burden (Hours)	833	833
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.