U.S. Origin Health Certificate

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0579-0020 can be found here:

Documents and Forms

Document Name Document Type
Form VS 17-140 U.S. Origin Health Certificate Form
VS 17-140 United States Origin Health Certificate vs17-140.pdf Form
VS 17-140A United States Origin Health Certificate - Continuation S VS 17-140A.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	U.S. Origin Health Certificate	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 9 CFR .301, .51, 91.6, .16, .19, .28 9 CFR 91.3, .5, .6, .9, 92.101, .215 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	VS 17-140	United States Origin Health Certificate	vs17-140.pdf		No		Paper Only
Form	VS 17-140A	United States Origin Health Certificate - Continuation Sheet	VS 17-140A.pdf		No		Paper Only

Line of Business: Natural Resources

Subfunction: Agricultural Innovation and Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,067	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	90,067	45,000	45,067
Annual IC Time Burden (Hours)	26,290	3,736	22,554
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.