Information Collection

Collections Specified in the Order--810.10(d)

IC 6106 under ICR 202409-0910-006 · OMB 0910-0432.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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Information Collection (IC) Details

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IC Title:

Collections Specified in the Order--810.10(d)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 21 CFR 810.17 ( a) 21 CFR 810.15 (b) 21 CFR 810.15(d) 21 CFR 810.12 (a-b) 21 CFR 810.15 (e) 21 CFR 810.16 (a-b) 21 CFR 810.14 21 CFR 810.15 (a-c) 21 CFR 810.10(d) 21 CFR 810.11(a)

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

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: 2

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	2	2
Annual IC Time Burden (Hours)	16	16
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.