Fast-Food and Full-Service Restaurants--Form FDA 3966

Survey on the Occurrence of Foodborne Illness Risk Factors in Selected Restaurant and Retail Foodservice Facility Types

Documents and Forms

Document Name Document Type
ICR Attachment B_RFS Marking Instructions 2-22-24.pdf Other-Instructions
FDA 3966 Restaurant Data Collection Record 0744_FDA 3966.pdf Form

Information Collection (IC) Details

IC Title:	Fast-Food and Full-Service Restaurants--Form FDA 3966	Agency IC Tracking Number:	ORA

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Instructions			ICR Attachment B_RFS Marking Instructions 2-22-24.pdf		Yes	No	Printable Only
Form	FDA 3966	Restaurant Data Collection Record	0744_FDA 3966.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 400	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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	400	-400	800
Annual IC Time Burden (Hours)	800	400	400
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.