Information Collection

Private Sector

IC 2183 under ICR 200804-0579-005 · OMB 0579-0101.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0579-0101 can be found here:

2025-02-10 - No material or nonsubstantive change to a currently approved collection
2024-10-10 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Document Name Document Type
Form VS 5-19C Private Sector Form
VS 5-18 Record of Animals Moved vs5-18.pdf www.aphis.usda.gov/library/forms/pdf/vs5_18.pdf Form
VS 5-19D Scrapie Epidemiology Report vs5-19d.pdf Form
VS 5-19 Flock Inspection and Epidemiology Report vs5-19.pdf Form
VS 5-20 Individual Animal Information Report vs5-20.pdf Form
VS 1-23 Appraisal and Indemnity Claim Form vs1-23.pdf Form
VS 1-23A Indemnity Worksheet - Owner/Company vs1-23a.pdf Form
VS 1-24 Proceeds from Animals Sold for Slaughter vs 1-24.pdf Form
VS 5-19C Scrapie PEMMP Inspection Report vs5-19c.pdf Form
VS 5-19 C Scarpie PEMMP Inspection Report (continuation sheet) vs5-19c2.pdf Form
VS 5-29 Cooperative State - Scrapie Control Program vs5-29.pdf Form
VS 5-29 A Scrapie Test Record - Continuation Sheet vs5-29a.pdf Form
VS 10-4 Specimen Submission vs10-4.pdf www.aphis.usda.gov/library/forms/pdf/VS_Form10_4.pdf Form
VS 5-22 Application for the Scrapie Flock Certification Program vs 5-22.pdf www.aphis.usda.gov/library/forms/pdf/vs5_22.pdf Form
VS 5-18 A Record of Animals Acquired vs5-18a.pdf www.aphis.usda.gov/library/forms/pdf/vs5_18.pdf Form
VS 5-19 A Flock Inspection and Epidemnity Report Initial Flock Ins vs5-19a.pdf Form
VS 5-19 b Flock Inspection and Epidemiology Report Flock Inspectio vs5-19b.pdf Form
VS 17-140 United States Origin Health Certificate vs17-140.pdf Form
VS 5-21 Agreement to Conduct the Official Histopathology Examina vs5-21.pdf Form
VS 1-27 Permit for Movement of Restricted Animals vs1-27.pdf Form

Information Collection (IC) Details

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:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VS 5-19C	Scrapie PEMMP Inspection Report	vs5-19c.pdf		No		Paper Only
Form	VS 5-19 C	Scarpie PEMMP Inspection Report (continuation sheet)	vs5-19c2.pdf		No		Paper Only
Form	VS 5-29	Cooperative State - Scrapie Control Program	vs5-29.pdf		No		Paper Only
Form	VS 5-29 A	Scrapie Test Record - Continuation Sheet	vs5-29a.pdf		No		Paper Only
Form	VS 10-4	Specimen Submission	vs10-4.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.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	vs5-18a.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	vs5-19a.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	vs5-19b.pdf		No		Paper Only
Form	VS 17-140	United States Origin Health Certificate	vs17-140.pdf		No		Paper Only
Form	VS 5-21	Agreement to Conduct the Official Histopathology Examination for the Diagnosis of Scrapie in Sheep and Goats and Bovine Spongiform Encephalopathy in Cattle	vs5-21.pdf		No		Paper Only
Form	VS 1-27	Permit for Movement of Restricted Animals	vs1-27.pdf		No		Paper Only
Form	VS 5-18	Record of Animals Moved	vs5-18.pdf	http://www.aphis.usda.gov/library/forms/pdf/vs5_18.pdf	Yes	No	Printable Only
Form	VS 5-19D	Scrapie Epidemiology Report	vs5-19d.pdf		No		Paper Only
Form	VS 5-19	Flock Inspection and Epidemiology Report	vs5-19.pdf		No		Paper Only
Form	VS 5-20	Individual Animal Information Report	vs5-20.pdf		No		Paper Only
Form	VS 1-23	Appraisal and Indemnity Claim Form	vs1-23.pdf		No		Paper Only
Form	VS 1-23A	Indemnity Worksheet - Owner/Company	vs1-23a.pdf		No		Paper Only
Form	VS 1-24	Proceeds from Animals Sold for Slaughter	vs 1-24.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:	FR Citation:

Number of Respondents: 113,056	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Farms, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 22 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	608,659	10,586	-152,127	750,200
Annual IC Time Burden (Hours)	661,217	12,144	563,922	85,151
Annual IC Cost Burden (Dollars)	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.