Form VS 4-1 VS 4-1 Application for Brucellosis Classification or Reclassifi

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0579-0047. The time required to complete this information collection is estimated to average 8 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.			OMB Approved 0579-0047 Exp. 00/00/0000
The information in this report is needed for effective monitoring and management of the Brucellosis Federal-State Cooperative Program (9 CFR Parts 51 and 78).
UNITED STATES DEPARTMENT OF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE VETERINARY SERVICES APPLICATION FOR BRUCELLOSIS CLASSIFICATION OR RECLASSIFICATION OF STATE (VS Memorandum 551.4) (Under the Uniform Methods and Rules for the Establishment and Maintenance of Class Free, A, B, or C)
STATE	OR AREA SMALLER THAN A STATE
APPLICATION FOR (“X” one) ADVANCEMENT CONTINUATION
QUALIFICATION – UNIFORM METHODS AND RULES
PART
APPLICATION – REQUEST (For Modified Certified Brucellosis Area or Certified Brucellosis – Free Area) The provisions of Uniform Methods and Rules have been met. We request that this (“X” one of the following) STATE / AREA be declared a Class _________________________________________________________________
SIGNATURE OF STATE OFFICIAL		DATE
SIGNATURE OF FEDERAL VETERINARIAN IN CHARGE		DATE
CERTIFICATION Veterinary Services hereby declares the above (“X” one) STATE / AREA A Class______________________________________________ State/Area for the period beginning ________________________ 20______________________ and ending _________________________ 20 _________________________
SIGNATURE OF CERTIFYING OFFICIAL		DATE

VS FORM 4-1

FEB 2009

STATE

OR AREA SMALLER THAN A STATE

GENERAL INFORMATION

1. HERD AND CATTLE POPULATION OF STATE/AREA

2. DETERMINED BY (“X” applicable item)

A. Total Herds

B. Number of Breeding Cows

Tax Records

Farm Survey

SRS Records

Previous Area Test

3. REPORT DATES: FROM

TO

BRUCELLOSIS FIELD BLOOD TESTING SUMMARY

HERD AND CATTLE CLASSIFICATIONS

NUMBER

RESULTS OF BLOOD TESTS

A. MCI reactors represented

B. Herds

C. Cattle

INFECTED HERDS

D. Number

E. Percent

4. Follow up blood tests of BRT suspicious herds.

5. Tests of herds of origin of MCI reactors having negative herd tests.

6. Tests of herds of origin of MCI reactors having reactors on herd tests.

7. Area herd tests.

8. All other complete initial herd blood tests revealing reactors in this reporting period.

9. Herd having virulent field infection (not proven otherwise). Deductions must be justified in a narrative report.

10. Percent of infection based on area population.

90 ÷ 1A %

BRUCELLOSIS SURVEILLANCE TESTING-MILK AND BLOOD

11. BRT tests.

Rounds per year

Total Herds subject to test

Herds with less than 3 rounds

12. Market cattle identification (MCI) surveillance at slaughter this state.

Test eligible cattle slaughtered

Blood samples collected

MCI Reactors found

13. Market cattle identification (MCI) surveillance (all other MCI tests including markets, farms, reports from other states).

Blood samples tested

MCI Reactors found

14. Total MCI surveillance.

Total MCI tests 12C + 13C

Total Reactors 12D + 13D

14D ÷ 14C %

NO. MCI REACTORS TRACED

IDENT. STATUS OF ANIMAL

A. TRACED TO KNOWN REACTOR HERDS

B. TRACED AND HERD TEST IS RECOMMENDED

C. TRACED AND HERD TEST NOT RECOMMENDED

D. TRACED TO DEALER

E. TRACED TO FEED LOT

F. TRACED TO ANOTHER STATE

G. UNABLE TO TRACE

15. Present

16. Absent

17. MCI REACTORS NOT TRACED TO HERDS OF ORIGIN

18. ADJUSTED MCI RATE

A. No. (14D minus total lines 15 and 16 plus total lines 15 and 16 cpls. D, E, and G)

B. Percent (17A ÷ 14D) %

A. No. MCI tests (line 14C)

B. Adjusted No. MCI reactors (line 14D minus line 5A, minus lines 15 and 16 cols. A and F)

C. Percent reactors (18B ÷ 18A) %

OTHER SPECIES OF DOMESTIC ANIMALS BLOOD TESTED

SPECIES

NUMBER

INFECTED

SPECIES

NUMBER

INFECTED

Herds

Animals

Herds

Animals

Herds

Animals

Herds

Animals

19.

22.

20.

23.

21.

24.

25. COMMENTS (use additional sheet if more space is required)

Vs FORM 4-1 (REVERSE)