Information Collection

1150.5(a), (b)(1) and (2); General identifying information provided by manufacturers and importers of FDA regulated tobacco products and Identification and removal information (monthly); Form FDA 3852

IC 207250 under ICR 202507-0910-002 · OMB 0910-0749.

Documents and Forms

Document Name Document Type
Form FDA 3852 1150.5(a), (b)(1) and (2); General identifying information provided by manufacturers and importers of FDA regulated tobacco products and Identification and removal information (monthly); Form FDA 3852 Form and Instruction
Form FDA 3852 Report of Tobacco Product Removals Subject to Tax 1150.5(a), (b)(1) and (2); General identifying information provided by manufacturers and importers of FDA regulated tobacco products and Identification and removal information (monthly); Form FDA 3852 Form and Instruction
FDA 3852 Report of Tobacco Product Removals Subject to Tax 0749_FDA 3852.pdf Form and Instruction
FDA 3852 Report of Tobacco Product Removals Subject to Tax 0749_FDA 3852.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	1150.5(a), (b)(1) and (2); General identifying information provided by manufacturers and importers of FDA regulated tobacco products and Identification and removal information (monthly); Form FDA 3852	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 21 CFR 1150

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FDA 3852	Report of Tobacco Product Removals Subject to Tax	0749_FDA 3852.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 820	Number of Respondents for Small Entity: 250

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	9,840	1,440	8,400
Annual IC Time Burden (Hours)	29,520	4,320	25,200
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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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