Information Collection

State

IC 205333 under ICR 201301-0579-005 · OMB 0579-0412.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VS 10-4 State	Form and Instruction
VS 10-4 Specimen Submission VS 10-4 Aug 2009.doc www.aphis.usda.gov/animal_health/lab_info_services/forms_publications.shtml	Form and Instruction

IC Title:

State

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 9 CFR 77.33(d)(2)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	VS 10-4	Specimen Submission	VS 10-4 Aug 2009.doc	http://www.aphis.usda.gov/animal_health/lab_info_services/forms_publications.shtml	Yes	No	Fillable Printable

Line of Business: Natural Resources

Subfunction: Agricultural Innovation and Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 25

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	7	7
Annual IC Cost Burden (Dollars)	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.