Information Collection

New Written Request to be Placed on the List

IC 37675 under ICR 202411-0910-005 · OMB 0910-0509.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3972 Online Application for Export List New Written Request to be Placed on the List	Form and Instruction
0509 Export Listing Module (ELM) Screenshots for PRA.pdf	Other-E-form Screenshots
0509 Export Listing Module (ELM) Screenshots for PRA.pdf	Other-E-form Screenshots
0509 - Chile guidance.pdf	Other-Agency Guidance
0509 - Chile guidance.pdf	Other-Agency Guidance
0839 - China guidance.pdf	Other-Agency Guidance
0839 - China guidance.pdf	Other-Agency Guidance
3972 Online Application for Export List PRA - 0509 Online Applications Export Lists Screenshot-030422.pdf	Form and Instruction
3972 Online Application for Export List PRA - 0509 Online Applications Export Lists Screenshot-030422.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

CFSAN

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 21 CFR 1.101; 1.101(b)(1)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-E-form Screenshots		Yes	Yes	Fillable Fileable
Other-Agency Guidance		Yes	Yes	Fillable Fileable
Other-Agency Guidance		Yes	Yes	Fillable Fileable
Form and Instruction	3972	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 167

Number of Respondents for Small Entity: 17

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	835	835
Annual IC Time Burden (Hours)	835	835
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.

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