Cosmetic Product Ingredient Statement Page 2

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This section applies only to requirements of the Paperwork Reduction Act of 1995.
*DO NOT SEND YOUR COMPLETED FORM TO THE PRA STAFF EMAIL ADDRESS BELOW.*
The burden time for this collection of information is estimated to average 20 minutes 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:
“An agency may not conduct or sponsor,
Department of Health and Human Services
Food and Drug Administration
and a person is not required to respond to, a
Office of Chief Information Officer
collection of information unless it displays a
currently valid OMB number.”
Paperwork Reduction Act (PRA) Staff
PRAStaff@fda.hhs.gov
FORM FDA 2512a (8/14) (BACK)

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