U.S. Origin Health Certificate

Forms and Documents

Document Name	Status
Form VS 17-140 U.S. Origin Health Certificate Form	Modified
2011 SS 0020 revised.doc Supporting Statement A	2011-03-30
2010 APHIS 79 - 0020.xls Supplementary Document	2011-01-11
2011 APHIS 71 - 0020.xls Supplementary Document	2011-03-30

IC Document Collections

IC ID	Document Title	Status
2093	U.S. Origin Health Certificate Form	Modified

ICR Details

OMB Control No: 0579-0020	ICR Reference No: 201010-0579-013
Status: Historical Active	Previous ICR Reference No: 200711-0579-005
Agency/Subagency: USDA/APHIS	Agency Tracking No:
Title: U.S. Origin Health Certificate
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/01/2011
	Date Received in OIRA: 01/31/2011
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved for a period of three years. However, prior to submitting this collection for renewal, APHIS will review and evaluate the feasibility and practicality of implementing an electronic entry system for those forms that do not require an original signature and do not travel with shipments. APHIS should include this evaluation and a timeline for implementation in the renewal request.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2014	36 Months From Approved	03/31/2011
Responses	72,754	0	90,067
Time Burden (Hours)	17,610	0	26,290
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this information collection is to gather information on animals exported from the US thereby preventing the international dissemination of animal disease.

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Authorizing Statute(s): US Code: 7 USC 8301 Name of Law: Animal Health Protection Act of 2002
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 153	08/10/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 17	01/26/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
U.S. Origin Health Certificate	VS 17-140, VS 17-140A, VS 17-140B, VS 17-145	United States Origin Health Certificate ,   United States Origin Health Certificate - Continuation Sheet ,   Continuation Sheet for United States Orgin Health Certificate ,   U.S. ORIGIN HEALTH CERTIFICATE FOR THE EXPORT OF HORSES FROM THE UNITED STATES TO CANADA

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	72,754	90,067	0	7,892	-25,205	0
Annual Time Burden (Hours)	17,610	26,290	0	3,946	-12,626	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The overall program change burden is +211. 1. There is a program change by adding the letter for Undue Hardship and VS Form 17-145 to this collection. By including these items the number of respondents increased by +631 respondents increasing the number of responses by 7,891 resulting in an increase of +3946 total burden hours. 2. The CFR considers recordkeeping normal business practice; therefore, the APHIS no longer includes recordkeeping as burden. There is a program change of -45,000 responses decreasing the total burden hours by -3,735. The overall adjustment to the total burden for this collection is -12,626. 1. There is a decrease in the number respondents accounted for VS Forms 17-140, 17-140A and 17-140B due to overestimated figures contained in the previous collection. There is adjustment of -1590 respondents, causing the number of responses to decrease by -25,150 resulting in a decrease in total burden by -12,575. 2. The burden for Markings (Tattoos, Ear Tags, or Brands) has been removed as a separate burden because the information is accounted on the VS Form 17-140. By removing the burden for Markings, there is an adjustment of -50 respondents causing the number of responses to decrease by -50 resulting in a decrease of -50 burden hours. 3. There was a decrease in the number of respondents accounted for the Application for Approval of Inspection Facilities, the number respondents decreased by -5 causing the number of responses to decrease by -5 resulting in a decrease in total burden hours by -1.

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Annual Cost to Federal Government: $1,123,776

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/31/2011

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