Smokeless Tobacco Nicotine and Ingredient Report

Annual Submission of the Ingredients Added to, and the Quantity of Nicotine Contained in, Smokeless Manufactured, Imported, or Packaged in the U.S.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0338 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-0338 Smokeless Tobacco Nicotine and Ingredient Report Form and Instruction
0920-0338 Ingredient Reporting Format 0920 0338 Att 4a Smokeless Tobacco Ing Report Format Final.pdf Form and Instruction
0920-0338 Nicotine Report Format 0920 0338 Att 4b Smokeless Tobacco Nicotine Report Format Final.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Smokeless Tobacco Nicotine and Ingredient Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 15 CFR 4401 18 CFR 1905

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-0338	Ingredient Reporting Format	0920 0338 Att 4a Smokeless Tobacco Ing Report Format Final.pdf	na	No		Paper Only
Form and Instruction	0920-0338	Nicotine Report Format	0920 0338 Att 4b Smokeless Tobacco Nicotine Report Format Final.pdf	na	No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11	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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	11	11
Annual IC Time Burden (Hours)	18,843	18,843
Annual IC Cost Burden (Dollars)	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.