APHIS Form 71

0304 APHIS 71 - Nov2009.pdf

USDA APHIS Peer Reviewer's Certification Regarding Conflict of Interest

APHIS Form 71

OMB: 0579-0304

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INSTRUCTIONS: Use this form when a single information collection document involves multiple
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
totals shall be computed, as follows, and then entered on the OMB 83-1.
(F) Total
(H) Total
(K) Total = (J) Average
= (E)
= (G)
(D) Total
(F) Total
(I) Total
A
A

TITLE OF INFORMATION COLLECTION DOCUMENT

PAGE

OMB NO.

0579- 0304

Peer Reviewer's - Conflict of Interest

DATE PREPARED

1

.........OF

11/05/2009
ANNUAL BURDEN

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
REPORTS
SECTION OF
REGULATIONS

DESCRIPTION

(B)

(A)

Peer Reviewer's Instruction Sheet and Form

TOTAL

APHIS FORM 71 (JAN 96)

(Previous editions are obsolete.)

1

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

NO. OF
RESPONDENTS

TOTAL
ANNUAL
RESPONSES
(Col. D x E)

(E)

(D)

(C)

APHIS
6004

NO. OF
RESPONSE
PER
RESPONDENT

RECORDS
HOURS
PER
RESPONSE

TOTAL
HOURS
(Col. F x G)

(G)

(F)

(H)

50

1

50

.25

13

50

1

50

.25

12.5

NO. OF
RECORD
KEEPERS
(I)

ANNUAL
HOURS
PER
RECORDKEEPER
(J)

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

SUMMARY OF INFORMATION COLLECTIONS (Public Burden)
USDA - APHIS

INSTRUCTIONS: Use this form when a single information collection document involves multiple
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
totals shall be computed, as follows, and then entered on the OMB 83-1.
(F) Total
(H) Total
(K) Total = (J) Average
= (E)
= (G)
(D) Total
(F) Total
(I) Total
A
A

TITLE OF INFORMATION COLLECTION DOCUMENT

PAGE

OMB NO.

0579DATE PREPARED
.........OF
ANNUAL BURDEN

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
REPORTS
SECTION OF
REGULATIONS
(A)

APHIS FORM 71 (JAN 96)

DESCRIPTION

(B)

(Previous editions are obsolete.)

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

NO. OF
RESPONDENTS
(D)

NO. OF
RESPONSE
PER
RESPONDENT
(E)

TOTAL
ANNUAL
RESPONSES
(Col. D x E)
(F)

RECORDS
HOURS
PER
RESPONSE
(G)

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

NO. OF
RECORD
KEEPERS
(I)

ANNUAL
HOURS
PER
RECORDKEEPER
(J)

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

SUMMARY OF INFORMATION COLLECTIONS (Public Burden)
USDA - APHIS


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File Titleaph71-2
File Modified2009-11-09
File Created2006-03-01

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