Coordination with third-party entities related to screener response

Small Dispensers Assessment Under the Drug Supply Chain Security Act

Documents and Forms

Document Name Document Type
SmallDispensersAssessment_AttachmentB_Screener_11.2025.docx Other-Screener

Information Collection (IC) Details

IC Title:	Coordination with third-party entities related to screener response	Agency IC Tracking Number:	CDER

Is this a Common Form? No		IC Status: New

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-Screener			SmallDispensersAssessment_AttachmentB_Screener_11.2025.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 692	Number of Respondents for Small Entity: 692

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

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to New Statute
Annual Number of Responses for this IC	1,384	1,384
Annual IC Time Burden (Hours)	138	138
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.