Information Collection

Public Health Information System

IC 196167 under ICR 201102-0583-001 · OMB 0583-0153.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0583-0153 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
PHIS Screen Shots for 9540-1 030711.pdf	Other-screens-Import Reinspection
Transfer certificate with OMB.docx	Other-screens-Transfer Certificate
split consolidation screen shot OMB statement.docx	Other-screens-Split Consolidation Ce
9080-4 product list screen shots OMB statement March 1 2011.docx	Other-screens-Product List
screen shots for 9080-3 OMB statement March 1 2011.docx	Other-screens-Est. Application for E
screen shots for 9060-6 OMB statement March 1 2011.docx	Other-screens-Application for Export
PHIS Sscreen shots 9010-1 030211.pdf	Other-screens-Application for Return
PHIS Sscreen shots 9010-1 030211.pdf	Other-Screen shots
5200-6 Application/Approval for Voluntary Inspection FSIS 5200-6.pdf	Form
5200-15 Hours of Operations FSIS 5200-15 Hours of Operation Request Approval .pdf	Form
5200-2 Application for Inspection FSIS 5200-2.pdf	Form
9540-1 Import Reinspection Application FSIS 9540-1_2.pdf	Form and Instruction
9080-4 Meat, Poultry, and Egg Product List FSIS 9080-4.pdf	Form
9080-3 Establishment Application for Export FSIS 9080-3 ESTABLISHMENT APPLICATION FOR EXPORT OF _v8508.pdf	Form and Instruction
9060-6 Application for Export Certificate FSIS 9060-6 .pdf	Form
FSIS 9010-1 Application for the Return of Exported Products to the U FSIS 9010-1 Application for the Return of Exported Products to the United States_v8RE508.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Public Health Information System

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-screens-Product List			9080-4 product list screen shots OMB statement March 1 2011.docx	Yes	Yes	Fillable Fileable
Form and Instruction	9080-3	Establishment Application for Export	FSIS 9080-3 ESTABLISHMENT APPLICATION FOR EXPORT OF _v8508.pdf	Yes	No	Fillable Printable
Other-screens-Est. Application for Export			screen shots for 9080-3 OMB statement March 1 2011.docx	Yes	Yes	Fillable Fileable
Form	9060-6	Application for Export Certificate	FSIS 9060-6 .pdf	Yes	No	Fillable Printable
Other-screens-Application for Export Certificate			screen shots for 9060-6 OMB statement March 1 2011.docx	Yes	Yes	Fillable Fileable
Other-screens-Application for Return of Exported Product			PHIS Sscreen shots 9010-1 030211.pdf	Yes	Yes	Fillable Fileable
Other-Screen shots			PHIS Sscreen shots 9010-1 030211.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	FSIS 9010-1	Application for the Return of Exported Products to the United States	FSIS 9010-1 Application for the Return of Exported Products to the United States_v8RE508.pdf	Yes	No	Fillable Printable
Form	5200-6	Application/Approval for Voluntary Inspection	FSIS 5200-6.pdf	Yes	Yes	Fillable Fileable
Form	5200-15	Hours of Operations	FSIS 5200-15 Hours of Operation Request Approval .pdf	Yes	Yes	Fillable Fileable
Form	5200-2	Application for Inspection	FSIS 5200-2.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	9540-1	Import Reinspection Application	FSIS 9540-1_2.pdf	Yes	No	Fillable Printable
Other-screens-Import Reinspection			PHIS Screen Shots for 9540-1 030711.pdf	Yes	Yes	Fillable Fileable
Other-screens-Transfer Certificate			Transfer certificate with OMB.docx	Yes	Yes	Fillable Fileable
Other-screens-Split Consolidation Certificate			split consolidation screen shot OMB statement.docx	Yes	Yes	Fillable Fileable
Form	9080-4	Meat, Poultry, and Egg Product List	FSIS 9080-4.pdf	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,067

Number of Respondents for Small Entity: 2,750

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	912,286	337,000	575,286
Annual IC Time Burden (Hours)	148,015	56,014	92,001
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.