Information Collection

State

IC 205333 under ICR 201301-0579-005 · OMB 0579-0412.

Documents and Forms

Document Name Document Type
Form VS 10-4 State Form and Instruction
VS 10-4 Specimen Submission VS 10-4 Aug 2009.doc www.aphis.usda.gov/animal_health/lab_info_services/forms_publications.shtml Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	State	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 9 CFR 77.33(d)(2)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	VS 10-4	Specimen Submission	VS 10-4 Aug 2009.doc	http://www.aphis.usda.gov/animal_health/lab_info_services/forms_publications.shtml	Yes	No	Fillable Printable

Line of Business: Natural Resources

Subfunction: Agricultural Innovation and Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	7	7
Annual IC Cost Burden (Dollars)	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.