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Federal forms, ICRs, and supporting documents

Information Collection

Select Agent Registration (State, Local & Tribal)

IC 186793 under ICR 201305-0579-007 · OMB 0579-0213.

Documents and Forms
Document Name
Document Type
Form and Instruction
Instruction
Instruction
Form
Form
Form
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Select Agent Registration (State, Local & Tribal)
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction APHIS/CDC Form 1 (Revised) Application for Registration for Possession, Use, and Transfer of Select Agents and Toxins APHIS-CDC Form 1 (Revised).docx http://www.selectagents.gov Yes Yes Fillable Fileable
Instruction REVISED Guidance Document for the Completion of APHIS-CDC Form 2 FINAL.doc http://www.selectagents.gov Yes Yes Fillable Printable
Form and Instruction APHIS/CDC Form 2 Request to Transfer Select Agents and Toxins APHIS-CDC Form 2 Request to Transfer Select Agents and Toxins.doc http://www.selectagents.gov Yes Yes Fillable Fileable
Form and Instruction APHIS/CDC Form 3 Report of Theft, Loss, or Release of Select Agents and Toxins APHIS-CDC Form 3 Notification of Theft, Loss or Release.docx http://www.selectagents.gov Yes Yes Fillable Fileable
Instruction Form 4 Guidance Document.doc http://www.selectagents.gov Yes Yes Fillable Printable
Form and Instruction APHIS/CDC Form 5 Request for Exemption of Select Agents and Toxins for Public Health or Agricultural Emergency or Investigational Product APHIS-CDC Form 5.doc http://www.selectagents.gov Yes Yes Fillable Fileable
Form VS 16-3 Application for Permit to Import or Transport Controlled Material or Organisms or Vectors VS 16-3 Apr 2009.pdf http://www.aphis.usda.gov/library/forms/pdf/VS_16_3.pdf Yes No Fillable Printable
Form VS 16-7 Additional Information for Cell Cultures and Their Products VS 16-7 Dec 2011.pdf http://www.aphis.usda.gov/library/forms/pdf/VS_16_7.pdf Yes No Fillable Printable
Form PPQ 526 Application and Permit to Move Live Plant Pests or Noxious Weeds PPQ 526 Dec 2011.pdf http://www.aphis.usda.gov/library/forms/pdf/PPQ_526.pdf Yes No Fillable Printable
Form and Instruction APHIS-CDC Form 4A Reporting the Identification of a Select Agent or Toxin in a Clinical/Diagnostic Specimen APHIS-CDC Form 4A ReferenceLab_SampleProvider Revised.doc http://www.selectagent.gov Yes Yes Fillable Fileable
Form and Instruction APHIS-CDC Form 4B Reporting the Identification of a Select Agent or Toxin: Proficiency Testing Report APHIS-CDC Form 4B ProficiencyTest doc Revised.doc http://www.selectagents.gov Yes Yes Fillable Fileable
Form and Instruction APHIS/CDC 4C Reporting the Identification of a Select Agent or Toxin: Federal Law Enforcement Seizure Report APHIS-CDC Form 4C FederalLaw Revised.doc www.selectagents.gov Yes Yes Fillable Fileable

Natural Resources Agricultural Innovation and Services

 

163 0
   
State, Local, and Tribal Governments
 
   75 %

  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 1,559 0 0 0 0 1,559
Annual IC Time Burden (Hours) 4,760 0 0 0 0 4,760
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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