Ingredient Report

List of Ingredients Added to Tobacco in the Manufacture of Cigarette Products

Documents and Forms

Document Name Document Type
Form 0920-0210 Ingredient Report Form and Instruction
0920-0210 Recommended Cigarette Ingredient Reporting Format - FCLA Recommended Cigarette Ingredient Reporting Format for OMB 2019.doc Form and Instruction
0920-0210 Recommended Cigarette Ingredient Reporting Format - FCLA Recommended Cigarette Ingredient Reporting Format for OMB 2019.doc Form and Instruction

Information Collection (IC) Details

IC Title:	Ingredient Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 18 CFR 1905 15 CFR 4401

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-0210	Recommended Cigarette Ingredient Reporting Format - FCLAA	Recommended Cigarette Ingredient Reporting Format for OMB 2019.doc	NA	No		Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 55	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	55	55
Annual IC Time Burden (Hours)	358	358
Annual IC Cost Burden (Dollars)	20,496	20,496

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.