aphis 71

INSTRUCTIONS: Use this form when a single information collection document involves multiple TITLE OF INFORMATION COLLECTION DOCUMENT
public reporting and recordkeeping requirements. The totals of the figures in cols. (d), (F), (H), (I)
and (K) should be entered in item 13 of OMB 83-1. For cols. (E), (G), & (J), the averages of the LOW PATHOGENIC AVIAN INFLUENZA; VOLUNTARY
totals shall be computed, as follows, and then entered on the OMB 83-1.
PROGRAM AND PAYMENT OF INDEMNITY
(F) Total
(H) Total = (G)
(K) Total = (J) Average
= (E)
(D) Total A
(F) Total
(I) Total
A

PAGE

OMB NO.

0579-

CONTROL

DATE PREPARED

1
1
.........OF........

7/15/2006
ANNUAL BURDEN

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
REPORTS
SECTION OF
REGULATIONS

DESCRIPTION

(B)

(A)

FORM NO(S).
(If "none",
so state)

(C)

NO. OF
RESPONSE
PER
RESPONDENT

NO. OF
RESPONDENTS

TOTAL
ANNUAL
RESPONSES
(Col. D x E)

(E)

(D)

RECORDS
HOURS
PER
RESPONSE
(G)

(F)

NO. OF
RECORD
KEEPERS

TOTAL
HOURS
(Col. F x G)
(H)

(I)

ANNUAL
HOURS
PER
RECORDKEEPER

TOTAL
RECORDKEEPING
HOURS
(Col. I x J)
(K)

(J)

MOU (Signature only)
146.4(a)

Recordkeeping

2300

20.000

46000

146.11(c)
146.14(b)

146.44(a)(iii)

146.13

Flock Selecting and Testing Report

most type chicken slaughter plants

VS 9-2

170

520

88400

0.083

7337

turkey slaughter plants

VS 9-2

50

12

600

0.083

50

table egg producers

VS 9-2

2000

1

2000

0.083

166

Summary of Breeding Flock Participation

VS 9-4

48

7

336

4.000

1344

Report of Hatcheries, Dealers and Independent Flocks

VS 9-5

48

2

96

0.500

48

1

1

1

0.500

1

Labs (Signature only)

Participating in NPIP

56.4(b), 56.4(a)

ALL SPECIES APPRAISAL AND INDEMNITY APPLICATION VS 1-23

56.9(b)

(SIGNATURE ONLY)

56.4(c), 56.6, 56.7

INDEMNITY WORKSHEET

VS 1-23A

2317
APHIS FORM 71 (JAN 96)

(Previous editions are obsolete.)

91433

8946

46000

SUMMARY OF INFORMATION COLLECTIONS (Public Burden)
USDA - APHIS