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| Question | Answer |
|---|---|
| Form Name | Form FDA 3455 |
| Form Length | 1 page |
| Fillable? | Yes |
| Fillable fields | 19 |
| Avg. time to fill out | 4 min |
| Edition | 4/26 |
| Issuing agency | Food and Drug Administration |
| OMB number | 0910-0396 |
| Expiration date | July 31, 2028 |
| Matches the agency's file | Yes, checked October 3, 2026 |
| Other names | FDA 3455, FDA3455, Form FDA 3455, Form 3455, FDA form 3455, 3455 FDA form, FDA financial disclosure form 3455, Disclosure: Financial Interests and Arrangements of Clinical Investigators |
| Official source | Form FDA 3455 (Rev 4/26), Food and Drug Administration |
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