View Information Collection (IC)

View Information Collection (IC)

IC Title:	U.S. Origin Health Certificate	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 9 CFR 91.3, .5, .6, .9, 92.101, .215 9 CFR .301, .51, 91.6, .16, .19, .28 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VS 17-140	United States Origin Health Certificate	vs17-140.pdf		No		Paper Only
Form	VS 17-140A	United States Origin Health Certificate - Continuation Sheet	VS 17-140a Apr 2003.pdf		No		Paper Only
Form	VS 17-140B	Continuation Sheet for United States Orgin Health Certificate	VS 17-140b JAN 2011.docx		No		Paper Only
Form	VS 17-145	U.S. ORIGIN HEALTH CERTIFICATE FOR THE EXPORT OF HORSES FROM THE UNITED STATES TO CANADA	VS 17-145 DEC 2010.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: 2,056	Number of Respondents for Small Entity: 205

Affected Public: Private Sector	Private Sector: Farms, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	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	72,754	0	7,892	-25,205	0	90,067
Annual IC Time Burden (Hours)	17,610	0	3,946	-12,626	0	26,290
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.