Information Collection

Gypsy Moth Checklist/Self Inspection - Individuals

IC 212532 under ICR 202102-0579-005 · OMB 0579-0104.

Documents and Forms

Document Name Document Type
Form PPQ Form 377 Gypsy Moth Checklist/Self Inspection - Individuals Form and Instruction
Form PPQ Form 377 Gypsy Moth Checklist and Record of Your Self-Inspection Gypsy Moth Checklist/Self Inspection - Individuals Form and Instruction
Form PPQ Form 377 Gypsy Moth Checklist and Record of Your Self-Inspection Gypsy Moth Checklist/Self Inspection - Individuals Form and Instruction
Form PPQ Form 377A Gypsy Moth Checklist and Record of Self-Inspection Gypsy Moth Checklist/Self Inspection - Individuals Form and Instruction
PPQ Form 377 Gypsy Moth Checklist and Record of Your Self-Inspection PPQ 377 SEP 2018 SEC (20190205).pdf www.aphis.usda.gov/library/forms/pdf/ppq377.pdf Form and Instruction
PPQ Form 377 Gypsy Moth Checklist and Record of Your Self-Inspection PPQ 377 SEP 2018 SEC (20190205).pdf www.aphis.usda.gov/library/forms/pdf/ppq377.pdf Form and Instruction
PPQ Form 377 Gypsy Moth Checklist and Record of Your Self-Inspection PPQ 377 GM Online Checklist Screenshots.pdf www.aphis.usda.gov/aphis/ourfocus/planthealth/plant-pest-and-disease-programs/pests-and-diseases/gypsy-moth/gm-checklist Form and Instruction
PPQ Form 377 Gypsy Moth Checklist and Record of Your Self-Inspection PPQ 377 GM Online Checklist Screenshots.pdf www.aphis.usda.gov/aphis/ourfocus/planthealth/plant-pest-and-disease-programs/pests-and-diseases/gypsy-moth/gm-checklist Form and Instruction
PPQ Form 377A Gypsy Moth Checklist and Record of Self-Inspection PPQ 377A GM Online Checklist screenshots.pdf Form and Instruction
PPQ Form 377A Gypsy Moth Checklist and Record of Self-Inspection PPQ 377A GM Online Checklist screenshots.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Gypsy Moth Checklist/Self Inspection - Individuals	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 7 CFR 301.45-4(a)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	PPQ Form 377	Gypsy Moth Checklist and Record of Your Self-Inspection	PPQ 377 SEP 2018 SEC (20190205).pdf	https://www.aphis.usda.gov/library/forms/pdf/ppq377.pdf	Yes	No	Fillable Printable
Form and Instruction	PPQ Form 377	Gypsy Moth Checklist and Record of Your Self-Inspection	PPQ 377 GM Online Checklist Screenshots.pdf	https://www.aphis.usda.gov/aphis/ourfocus/planthealth/plant-pest-and-disease-programs/pests-and-diseases/gypsy-moth/gm-checklist	Yes	No	Fillable Printable
Form and Instruction	PPQ Form 377A	Gypsy Moth Checklist and Record of Self-Inspection	PPQ 377A GM Online Checklist screenshots.pdf		Yes	No	Fillable Printable

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: 2,500,000	Number of Respondents for Small Entity: 2,450,000

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 60 %

	Approved	Previously Approved
Annual Number of Responses for this IC	5,000,000	5,000,000
Annual IC Time Burden (Hours)	2,707,500	2,707,500
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.

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