Specimen Submission

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form VS 10-4 Specimen Submission - State	Form and Instruction	Modified	Available
Form VS 5-38 Specimen Submission - Individual	Form and Instruction	Removed	Available
Form VS 5-38 Specimen Submission - Business	Form and Instruction	Modified	Available
2013 SS 0090.docx	Supporting Statement A	Uploaded 2012-12-07	Available
2013 aphis 79 - 0090.xlsx	Supplementary Document	Uploaded 2012-12-03	Available
2013 aphis 71 - 0090 correction.xlsx	Supplementary Document	Uploaded 2012-12-03	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
43536	Specimen Submission - State	Form and Instruction	Modified
190878	Specimen Submission - Individual	Form and Instruction	Removed
190824	Specimen Submission - Business	Form and Instruction	Modified

ICR Details

OMB Control No: 0579-0090	ICR Reference No: 201212-0579-001
Status: Historical Active	Previous ICR Reference No: 200909-0579-007
Agency/Subagency: USDA/APHIS	Agency Tracking No:
Title: Specimen Submission
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/13/2013
	Date Received in OIRA: 12/26/2012
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/29/2016	36 Months From Approved	02/28/2013
Responses	28,100	0	28,100
Time Burden (Hours)	9,267	0	9,267
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this collection is to identify the individual animal from which specimens were taken, the animal's herd or flock, the type of specimen submitted, and the purpose for submitting the specimen.

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Authorizing Statute(s): PL: Pub.L. 107 - 171 10401 Name of Law: The Animal Health Protection Act
  

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:
	77 FR 138	07/18/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 247	12/26/2012
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Specimen Submission - State	VS 10-4, VS 10-4A, VS 5-38	SPECIMEN SUBMISSION ,   SPECIMEN SUBMISSION CONTINUATION SHEET ,   PARASITE SUBMISSION FORM
Specimen Submission - Business	VS 10-4A, VS 5-38, VS 10-4	PARASITE SUBMISSION FORM ,   SPECIMEN SUBMISSION ,   SPECIMEN SUBMISSION CONTINUATION SHEET
Specimen Submission - Individual	VS 5-38	Parasite Submission Form

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ICR Summary of Burden

table that charts list 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	28,100	28,100	0	0	0	0
Annual Time Burden (Hours)	9,267	9,267	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: There is no change in burden for this 3-year renewal information collection.

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Annual Cost to Federal Government: $293,857

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: 12/26/2012

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