Information Collection

Pre-letter, invitation, reminder, survey

IC 263599 under ICR 202411-0910-006 · OMB 0910-0929.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix A. Survey.docx	Other-Survey
Appendix A. Survey.docx	Other-Survey
Appendix B. Pre-Notification Letter.docx	Other-Pre-notification letter
Appendix B. Pre-Notification Letter.docx	Other-Pre-notification letter
Appendix C. Invitation Letter.docx	Other-Invitation letter
Appendix C. Invitation Letter.docx	Other-Invitation letter
Appendix D. Reminder Postcard.docx	Other-Reminder postcard
Appendix D. Reminder Postcard.docx	Other-Reminder postcard
Appendix E. Final letter.docx	Other-Final letter
Appendix E. Final letter.docx	Other-Final letter
Appendix F. Official FDA Announcement.docx	Other-FDA announcement of survey
Appendix F. Official FDA Announcement.docx	Other-FDA announcement of survey
Appendix G. Post-Paid Incentive Letter.docx	Other-Post incentive letter
Appendix G. Post-Paid Incentive Letter.docx	Other-Post incentive letter

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey	Yes	Yes	Fillable Fileable
Other-Pre-notification letter	Yes	Yes	Printable Only
Other-Invitation letter	Yes	Yes	Fillable Fileable
Other-Reminder postcard	Yes	No	Printable Only
Other-Final letter	Yes	Yes	Fillable Fileable
Other-FDA announcement of survey	Yes	No	Printable Only
Other-Post incentive letter	Yes	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,493

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	4,493	1,500	2,993
Annual IC Time Burden (Hours)	1,250	156	1,094
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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