Information Collection

Notification, Documentation, and Recordkeeping

IC 188892 under ICR 202103-0583-006 · OMB 0583-0144.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0583-0144 can be found here:

Documents and Forms

Document Name Document Type
Form 5720-16 Notification, Documentation, and Recordkeeping Form
PHIS screenshot for 0583-0144 electronic data collection report of adulteration or misbranding.docx Other-screenshot for electronic repo
PHIS screenshot for 0583-0144 electronic data collection report of adulteration or misbranding.docx Other-screenshot for electronic repo
1 - Notifier Page.JPG Other-PHIS APM
1 - Notifier Page.JPG Other-PHIS APM
2 - Establishments Page.JPG Other-PHIS APM
2 - Establishments Page.JPG Other-PHIS APM
3-1 - Product Page top.JPG Other-PHIS APM
3-1 - Product Page top.JPG Other-PHIS APM
3-2 -Product Page bottom.JPG Other-PHIS APM
3-2 -Product Page bottom.JPG Other-PHIS APM
3-3 - Product Page (Issues)JPG.JPG Other-PHIS APM
3-3 - Product Page (Issues)JPG.JPG Other-PHIS APM
4 - Attachments Page.JPG Other-PHIS APM
4 - Attachments Page.JPG Other-PHIS APM
5 - Summary Page (no data entry).JPG Other-PHIS APM
5 - Summary Page (no data entry).JPG Other-PHIS APM
Wizard 1 - Notifier .JPG Other-PHIS APM
Wizard 1 - Notifier .JPG Other-PHIS APM
5720-16 Industry Report of Adulteration FSIS 5720-16 Industry Report of Adulteration.pdf Form
5720-16 Industry Report of Adulteration FSIS 5720-16 Industry Report of Adulteration.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Notification, Documentation, and Recordkeeping	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 9 CFR 418.3 9 CFR 418.2 9 CFR 417.4(a)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5720-16	Industry Report of Adulteration	FSIS 5720-16 Industry Report of Adulteration.pdf	Yes	Yes	Fillable Fileable
Other-screenshot for electronic reporting through PHIS			PHIS screenshot for 0583-0144 electronic data collection report of adulteration or misbranding.docx	Yes	Yes	Fillable Fileable
Other-PHIS APM			1 - Notifier Page.JPG	Yes	Yes	Fillable Fileable
Other-PHIS APM			2 - Establishments Page.JPG	Yes	Yes	Fillable Fileable
Other-PHIS APM			3-1 - Product Page top.JPG	Yes	Yes	Fillable Fileable
Other-PHIS APM			3-2 -Product Page bottom.JPG	Yes	Yes	Fillable Fileable
Other-PHIS APM			3-3 - Product Page (Issues)JPG.JPG	Yes	Yes	Fillable Fileable
Other-PHIS APM			4 - Attachments Page.JPG	Yes	Yes	Fillable Fileable
Other-PHIS APM			5 - Summary Page (no data entry).JPG	Yes	Yes	Fillable Fileable
Other-PHIS APM			Wizard 1 - Notifier .JPG	Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,300	Number of Respondents for Small Entity: 2,900

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	42,900	2,940	39,960
Annual IC Time Burden (Hours)	9,960	-37,515	47,475
Annual IC Cost Burden (Dollars)	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.