Information Collection

State

IC 218105 under ICR 201805-0579-005 · OMB 0579-0209.

Documents and Forms

Document Name Document Type
Form APHIS 2080 State Form
APHIS 2080 Adverse Event Report APHIS 2080 SEP 2015 (SECURE).pdf Form
APHIS 2081 Adverse Event Report Follow-up Information APHIS 2081 SEP 2015 (SECURE).pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	State	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 9 CFR 116.9

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	APHIS 2080	Adverse Event Report	APHIS 2080 SEP 2015 (SECURE).pdf		Yes	Yes	Fillable Fileable
Form	APHIS 2081	Adverse Event Report Follow-up Information	APHIS 2081 SEP 2015 (SECURE).pdf		Yes	Yes	Fillable Fileable

Line of Business: Natural Resources

Subfunction: Agricultural Innovation and Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,333	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,333	5,333
Annual IC Time Burden (Hours)	10,666	10,666
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.