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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
State, Local, or Tribal Government
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
VS 5-18
Record of Animals Moved
VS 5-18 Dec 2011.pdf
http://www.aphis.usda.gov/library/forms/pdf/vs5_18.pdf
Yes
No
Printable Only
Form
VS 5-19
FLOCK INSPECTION AND EPIDEMIOLOGY REPORT
VS 5-19 DEC 2011.pdf
No
Paper Only
Form
VS 5-19 D
Scrapie Epidemiology Report
VS 5-19D Feb 2011.pdf
No
Paper Only
Form
VS 5-20
Individual Animal Information Report
VS 5-20 DEC 2011.pdf
No
Paper Only
Form
VS 1-23
Appraisal and Indemnity Claim Form
VS 1-23 Apr 2009.doc
No
Paper Only
Form
VS 1-23 A
Indemnity Worksheet - Owner/Company
VS 1-23A-work May 2009.doc
No
Paper Only
Form
VS 5-19C
Scrapie PEMMP Inspection Report
VS 5-19C Feb 2011.pdf
No
Paper Only
Form
VS 5-29
Cooperative State - Scrapie Control Program
VS 5-29 DEC 2011.pdf
No
Paper Only
Form
Vs 5-29A
Scrapie Test Record - Continuation Sheet
VS 5-29A DEC 2011.pdf
No
Paper Only
Form
VS 10-4
Specimen Submission
VS 10-4 Aug 2009.doc
http://www.aphis.usda.gov/library/forms/pdf/VS_Form10_4.pdf
Yes
No
Printable Only
Form
Vs 5-19A
Flock Inspection and Epidemiology Report Initial Flcok Inspection for Complete Monitored Status in Scrapie Flock Certification Program
VS 5-19A Mar 2010.doc
No
Paper Only
Form
Vs 5-19b
Flock Inspection and Epidemiology Report Flock Inspection for Complete Monitored Status in the Scrapie Flock Certification Program
VS 5-19B Mar 2010.doc
No
Paper Only
Form
VS 5-24
Application for Scrapie Classification, Classification Renewal, or Reclassification of a State
VS 5-24 Apr 2010.doc
No
Paper Only
Form
VS 5-18A
RECORD OF ANIMALS ACQUIRED
VS 5-18A Dec 2011.pdf
No
Paper Only
Form
VS 1-27
PERMIT FOR MOVEMENT OF RESTRICTED ANIMALS
VS 1-27 JUL 2011.doc
http://www.aphis.usda.gov/library/forms
Yes
No
Printable Only
Form
VS 17-140
UNITED STATES ORIGIN HEALTH CERTIFICATE
VS 17-140 SEP 2010.docx
http://www.aphis.usda.gov/library/forms
Yes
No
Printable Only
Form
VS 5-21
AGREEMENT TO CONDUCT THE OFFICIAL HISTOPATHOLOGY
VS 5-21 DEC 2011.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Natural Resources
Subfunction:
Agricultural Innovation and Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
489
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
18 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
7,736
0
0
6,118
0
1,618
Annual IC Time Burden (Hours)
33,142
0
0
21,726
0
11,416
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SF 424
SF 424.pdf
11/07/2012
SF 424A
SF 424 A.pdf
11/07/2012
SF 424B
SF 424 B.pdf
11/07/2012
SF LLL
SF LLL.pdf
11/07/2012
SF 425
SF 425.pdf
11/07/2012
MOU
mou.pdf
11/07/2012
How to Create an On-Line CVI for AV
How to Create an On-Line CVI for AV.ppt
11/15/2012
Appendix A-1 FY 2010 Scrapie CA Guidance
Appendix A-1 FY 2010 Scrapie CA Guidance.docx
11/15/2012
Appendix A-2 Coop Agreement Award ASI 10-9100-1231
Appendix A-2 Coop Agreement Award ASI 10-9100-1231.pdf
11/15/2012
Appendix A-3 NIAAGrant
Appendix A-3 NIAAGrant.pdf
11/15/2012
Appendix A-4_ MOU template for scrapie
Appendix A-4_ MOU template for scrapie.doc
11/15/2012
Appendix B_10-4 and 5-29 worksheets
Appendix B_10-4 and 5-29 worksheets.docx
11/15/2012
Appendices C-E screenshots
Appendices C-E screenshots.doc
11/15/2012
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.