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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 2011.pdf
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
VS 1-23 AUG 2018.pdf
No
Paper Only
Form
VS 1-23A
Indemnity Worksheet - Owner/Company
VS 1-23A-work May 2009.pdf
No
Paper Only
Form
VS 1-24
Proceeds from Animals/Animal Products/Materials Sold for Salvage
VS 1-24 AUG 2018 (SECURE).pdf
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 5-29 A
Scrapie Test Record - Continuation Sheet
VS 5-29A DEC 2011.pdf
No
Paper Only
Form
VS 10-4
Specimen Submission
VS 10-4 FEB 2021 SEC.pdf
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
VS 5-22 June 2013.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_18a.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
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
VS 5-19B June 2013 Final.pdf
No
Paper Only
Form
VS 17-140
United States Origin Health Certificate
VS 17-140 AUG 2018.pdf
No
Paper Only
Form
VS 1-27
Permit for Movement of Restricted Animals
VS 1-27 JUL 2011 (OMB).pdf
No
Paper Only
Form
VS 5-10
TERMINAL FEEDLOT APPROVAL
VS 5-10 NOV 2018).pdf
No
Paper Only
Form
VS 5-13
OWNER / HAULER STATEMENT FOR SHEEP AND GOATS
VS 5-13 NOV 2018.pdf
No
Paper Only
Form
VS 10-4A
Continuation Sheet for Specimen Submission
VS 10-4A AUG 2009 (20200629) Secure.pdf
Yes
No
Fillable Printable
Form
VS 5-13
Owner/Hauler Statement for Sheep and Goats
VS 5-13 NOV 2018.pdf
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:
174,783
Number of Respondents for Small Entity:
169,540
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Farms, Not-for-profit institutions
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
1,063,788
0
-667,367
436
0
1,730,719
Annual IC Time Burden (Hours)
810,927
0
-111,823
-66,857
0
989,607
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Grant and Coop Agreement Guide
FY23 VS Grant and Cooperative Agreements Recipient Guide.pdf
10/10/2023
MOU Template
MOU template.docx
10/10/2023
On-Farm Worksheet
On-farm_worksheet.pdf
10/10/2023
VSLS Goat RSSS Collection Worksheet Circle
VSLS Goat RSSS_Collection_worksheet_Circle choice.pdf
10/10/2023
VSLS Goat RSSS Collection Worksheet Fill-in
VSLS Goat RSSS_Collection_worksheet_Fill in.pdf
10/10/2023
VSLS Sheep RSSS Collection Worksheet Circle
VSLS Sheep RSSS_Collection_worksheet_Circle choice.pdf
10/10/2023
VSLS Sheep RSSS Collection Worksheet Fill-in
VSLS sheep RSSS_Collection_worksheet_Fill in.pdf
10/10/2023
Appdx C thru E VSLS AIMS Screenshots
Appendix C-E Screen Shots SCS-SCR VSLS AIMS_Redacted.pdf
10/10/2023
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.