OMB control number

Gypsy Moth Identification Worksheet

OMB 0579-0104 · USDA/APHIS.

OMB 0579-0104

The identification worksheet is needed to evaluate and control Gypsy Moth infestations from entering the United States.

The latest form for Gypsy Moth Identification Worksheet expires 2026-08-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form PPQ-391 Insect Collection Worksheet for Genotype Analysis Form
Form PPQ-391 Insect Collection Worksheet - State Form
Form PPQ Form 377A Gypsy Moth Checklist and Record of Self-Inspection Form and Instruction
Form PPQ Form 377 Gypsy Moth Checklist and Record of Your Self-Inspection Form and Instruction
Form PPQ Form 377 Gypsy Moth Checklist and Record of Your Self-Inspection Form and Instruction
Form PPQ Form 377 Gypsy Moth Checklist/Self Inspection - Individuals Form and Instruction
0104 2021 APHIS 79 (20210913) amended.xlsx Supplementary Document
0104 2021 APHIS 71 (20210913) amended.xlsx Supplementary Document
0104 2022 comment 1.pdf Public Comments
0104 2021 SS (202100921) amended - final.docx Supporting Statement A
0104 2021 SS (20210921).docx Supporting Statement A
0104 2021 APHIS 79 (20210913).xlsx Supplementary Document
0104 2021 APHIS 79 (20210913).xlsx Supplementary Document
0104 2021 APHIS 71 (20210913).xlsx Supplementary Document
0104 2021 APHIS 71 (20210913).xlsx Supplementary Document
Moving Industry Notification of Homeowners - Business
Insect Collection Worksheet - State Form
Insect Collection Worksheet - State Form
Gypsy Moth Checklist/Self Inspection - Individuals Form and Instruction
Gypsy Moth Checklist/Self Inspection - Individuals Form and Instruction
Gypsy Moth Checklist/Self Inspection - Individuals Form and Instruction
Gypsy Moth Checklist/Self Inspection - Individuals Form and Instruction

All Historical Document Collections

202102-0579-005 Approved with change	Extension without change of a currently approved collection	2021-09-22
201712-0579-007 Approved with change	Revision of a currently approved collection	2017-12-27
201403-0579-002 Approved without change	Revision of a currently approved collection	2014-08-19
201010-0579-021 Approved without change	Extension without change of a currently approved collection	2011-07-06
200802-0579-004 Approved without change	Extension without change of a currently approved collection	2008-07-16
200505-0579-003 Approved without change	Revision of a currently approved collection	2005-05-12
200203-0579-005 Approved without change	Revision of a currently approved collection	2002-03-29
199809-0579-005 Approved without change	Revision of a currently approved collection	1998-09-21
199508-0579-002 Approved without change	Revision of a currently approved collection	1995-08-07
199209-0579-001 Approved without change	Revision of a currently approved collection	1992-09-14
199206-0579-001 Approved without change	New collection (Request for a new OMB Control Number)	1992-06-22

OMB Details

Federal Enterprise Architecture: Natural Resources - Agricultural Innovation and Services

Form PPQ-391

Form

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.