General identifying information provided by manufacturers and importers of FDA regulated tobacco products and Identification and removal information (monthly); Form FDA 3852

Tobacco Products, User Fees, Requirements for the Submission of Data Needed to Calculate User Fees for Domestic Manufacturers and Importers of Tobacco Products

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0749 can be found here:

Documents and Forms

Document Name Document Type
Form FDA 3852 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 FDA-Form-3852 4.2021.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	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	FDA-Form-3852 4.2021.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: 700	Number of Respondents for Small Entity: 250

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

Percentage of Respondents Reporting Electronically: 90 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	8,400	504	7,896
Annual IC Time Burden (Hours)	25,200	1,512	23,688
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.