Information Collection

1150.5(b)(3); Certified copies (monthly)

IC 207251 under ICR 202507-0910-002 · OMB 0910-0749.

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Information Collection (IC) Details

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IC Title:	1150.5(b)(3); Certified copies (monthly)	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

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)	9,840	1,440	8,400
Annual IC Cost Burden (Dollars)	0	0	0

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