View Information Collection (IC)

View Information Collection (IC)

IC Title:	CDRH Export Certificate (FDA 3613, 3613a, 3613c)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FDA 3613	Supplementary Information Certificate to Foreign Government Requests	FDA-3613.pdf		Yes	No	Fillable Printable
Form and Instruction	FDA 3613a	Supplementary Information Certificdate of Exportability Requests	FDA-3613a.pdf		Yes	No	Fillable Printable
Form and Instruction	FDA 3613c	Supplementary Information Non-Clinical Research Use Only Certificate	FDA-3613c.pdf		Yes	No	Fillable Printable

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: 6,463	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Requested	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	6,463	0	0	372	0	6,091
Annual IC Time Burden (Hours)	12,926	0	0	744	0	12,182
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.