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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Private Sector
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
9 CFR 54.2 - 54.21, 79.2 - 79.6
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 5-19D
Scrapie Epidemiology Report
VS 5-19D Feb_FINAL.doc
No
Paper Only
Form
VS 5-19
Flock Inspection and Epidemiology Report
VS 5-19 DEC 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
REV VS 1-23 Sep 2010.pdf
No
Paper Only
Form
VS 1-23A
Indemnity Worksheet - Owner/Company
VS 1-23A-work May 2009.doc
No
Paper Only
Form
VS 1-24
Proceeds from Animals Sold for Slaughter
VS 1-24 DEC 2011.docx
No
Paper Only
Form
VS 5-19C
Scrapie PEMMP Inspection Report
VS 5-19C Feb_FINAL.pdf
No
Paper Only
Form
VS 5-29
Cooperative State - Scrapie Control Program
VS 5-29 DEC 2011.pdf
No
Paper Only
Form
VS 5-29 A
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 5-22
Application for the Scrapie Flock Certification Program
REV VS 5-22 June 2013 Final.pdf
http://www.aphis.usda.gov/library/forms/pdf/vs5_22.pdf
Yes
No
Printable Only
Form
VS 5-18 A
Record of Animals Acquired
VS 5-18A Dec 2011.pdf
http://www.aphis.usda.gov/library/forms/pdf/vs5_18.pdf
Yes
No
Printable Only
Form
VS 5-19 A
Flock Inspection and Epidemnity Report Initial Flock Inspection for Complete Monitored Status in SCrapie Flock Certification Program
REV VS 5-19A June 2013 Final.pdf
No
Paper Only
Form
VS 5-19 b
Flock Inspection and Epidemiology Report Flock Inspection for Complete Monitored Status in the Scrapie Flock Certification Program
REV VS 5-19B June 2013 Final.pdf
No
Paper Only
Form
VS 17-140
United States Origin Health Certificate
REV VS 17-140 NOV 2014.pdf
No
Paper Only
Form
VS 1-27
Permit for Movement of Restricted Animals
VS 1-27 JUL 2011.doc
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:
Animal health Surveillance and Monitoring System
FR Citation:
76 FR 228
Number of Respondents:
56,934
Number of Respondents for Small Entity:
55,000
Affected Public:
Private Sector
Private Sector:
Farms, Not-for-profit institutions, Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
25 %
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
853,731
0
853,731
0
0
0
Annual IC Time Burden (Hours)
958,989
0
958,989
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
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.