View Information Collection (IC)
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View Information Collection (IC)
View Information Collection (IC)
IC Title:
Reporting: PMTA submission; amendment; unique identification for new products; validator spreadsheet; periodic reports; change in ownership; supplemental applications; resubmissions; waiver
Agency IC Tracking Number:
CTP
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
21 CFR 1114.5
21 CFR 1114.9
21 CFR 1114.13
21 CFR 1114.17
21 CFR 1114.41
21 CFR 1114.45
21 CFR 1114.49
21 CFR 1114.15
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
FDA 4057
Premarket Tobacco Product Application (PMTA) Submission
FDA_Form_4057 (2024).pdf
Yes
Yes
Fillable Fileable Signable
Form and Instruction
FDA 4057a
Premarket Tobacco Product Application (PMTA) Amendment and General Correspondence Submission
FDA_Form_4057a (2024).pdf
Yes
Yes
Fillable Fileable Signable
Form and Instruction
FDA 4057b
Unique Identifying Information for New Tobacco Products
FDA 4057b ProductGrouping_v3.1_10-2024.xlsm
Yes
Yes
Fillable Fileable
Other-Validator Tool Screenshots
0879_Validation Tool 2.0_Screenshots (2024).pdf
Yes
Yes
Printable Only
Form and Instruction
FDA Web Form 4057
Premarket Tobacco Product Application (PMTA) Submission (FDA Web Form 4057)
Final Wireframes for FDA Web Form 4057 (PMTA) (2024).pdf
Yes
Yes
Fillable Fileable Signable
Form and Instruction
FDA Web Form 4057a
Premarket Tobacco Product Application (PMTA) Amendment and General Correspondence Submission (FDA Web Form 4057a)
Final Wireframes for FDA Web Form 4057a (PMTA Amendment) (2024).pdf
Yes
Yes
Fillable Fileable Signable
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:
215
Number of Respondents for Small Entity:
10
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
93 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,276
0
24
1,061
0
191
Annual IC Time Burden (Hours)
382,828
0
17
369,104
0
13,707
Annual IC Cost Burden (Dollars)
0
0
0
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.