Unique Identifying Information for New Tobacco Products | DRAFT FDA FORM 4057b | |||||||||||
Instructions: 1. First, enter Applicant Name then Product Category and Subcategory as required by 21 CFR § 1114.7(c)(3). 2. Click "Enter Unique Product Properties" button then enter applicable product information as specified in Table 1 to 21 CFR § 1114.7(c)(3)(iii) under the Product Tab. 3. Verify completion then SAVE AS .XLS or .XLSX and name appropriately. Must be XLS or XLSX to attach to eSubmitter file for submission. |
Please note: | OMB Control No. 0910-0879 Expiration Date: xx/xx/xxxx See PRA Statement on bottom of page |
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Product Information | Saving as an .xls or .xlsx will cause all drop down menus to disappear, so be certain you are completely finished. Your data will be saved, but you will not have drop down functions if you must re-open. Continue through the errors and save the file as "Tobacco_Product_list.xls" or "Tobacco_Product_list.xlsx". If there are multiple product files, save the files as "Tobacco_Product_list_n.xls" or "Tobacco_Product_list_n.xlsx"(where n=1,2,3,etc.) Use "Additional Property" to differentiate the products if all the other unique product properties are exactly the same. If you categorize your product as "other" in rows 5 and 6, please enter the "other" category information in rows 7 and 8. The "Product" tab will then be populated with all the unique product properties listed in Tables 1 -21. Use the "Reset" button to delete all data previously entered in the "Introduction" tab and reset the columns in the "Product" tab. |
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Applicant Name | ||||||||||||
Product Category | ||||||||||||
Product Subcategory | ||||||||||||
Product Category, If other | ||||||||||||
Product Subcategory, if Other | ||||||||||||
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Version: 2.0 | ||||||||||||
Release Date: 03/02/2020 | ||||||||||||
This section applies only to requirements of the Paperwork Reduction Act of 1995. *DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF ADDRESS BELOW.* The burden time for this collection of information is estimated to average 4 hours per response, including the time to review instructions, search existing data sources, gather and maintain the data needed and complete and review the collection of information. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden, to the following email address: For PRA questions: PRAStaff@fda.hhs.gov OMB Statement: “An agency may not conduct or sponsor and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number.” |
Product Name | Package Type | Package Type, if Other | Product Quantity Numeric Value | Units (Product Quantity) | Units (Product Quantity Mass) | Units, if Other (Product Quantity Mass) | Characterizing Flavor | Characterizing Flavor, If other | Tobacco Cut Style | Portion Count Numeric Value | Units (Portion Count) | Units, if Other (Portion Count) | Portion Mass Numeric Value | Units (Portion Mass) | Length Description | Length Description, if Other | Length Numeric Value | Units (Length) | Width Numeric Value | Units (Width) | Diameter Description | Diameter Description, if Other | Diameter Format | Diameter Numeric Value | Units (Diameter) | Portion Thickness Numeric Value | Units (Portion Thickness) | Ventilation | E-liquid Volume | E-liquid Volume Units | Nicotine Concentration | Nicotine Concentration Units | Units, if Other (Nicotine Concentration) | PG/VG Ratio | PG/VG Not Applicable | Wattage Numeric Value | Units (Wattage) | Units, if Other (Wattage) | Battery Capacity Numeric Value | Units (Battery Capacity) | Units, if Other (Battery Capacity) | Tip Type | Tip Type, if Other | Wrapper Material | Wrapper Material, if Other | Number of Hoses | Source of Energy | Source of Energy, if Other | Height Numeric Value | Units (Height) | Additional Properties (if Applicable) |
File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |