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APHIS Form 71

ICR 201304-0579-006 · OMB 0579-0335 · Object 39332601.

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APHIS Form 71
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2013-04-25
2026-09-13
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REPRODUCE LOCALLY. Include form number and date on all reproductions.

Page 1 of 4

SUMMARY OF INFORMATION COLLECTION

INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and
recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1:
cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b;
cols. H & K = 13c.

TITLE OF INFORMATION COLLECTION DOCUMENT

OMB NO.

National Management Information System - pg 1 of 4

0579-0335

(F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average
(K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6
years, list as "1/6" & decimal will display.

DATE PREPARED

August 9, 2012
ANNUAL BURDEN

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT

REPORTS

RECORDS
TOTAL

SECTION OF
REGS.

FORMS NO (S)
(If "none"
so state)

DESCRIPTION

NO. OF
RESPONDENTS

NO OF
RESPONSES
PER

TOTAL ANNUAL
RESPONSES
(Col. D x E)

HOURS
PER
RESPONSE

TOTAL
HOURS
(Col. F x G)

NO. OF
RECORDKEEPERS

ANNUAL
HOURS PER
RECORD-

RESPONDENT
(A)

(B)

(C)

Work Initiation Document for Wildlife Damage
Management (individual)

12A/12A
Addendum

Work Initiation Document for Wildlife Damage
Management (Private Sector)

12A/12A
Addendum

426; 426b

Work Initiation Document for Wildlife Damage
Management (State, Local or Tribal Group)

12A/12A
Addendum

426; 426b

Work Initiation Document for Wildlife Damage
Management (Multiple Resource Owners)
(individual)

426; 426b

426; 426b

(D)

(E)

RECORDKEEPING HOURS

(Col. I x J)

KEEPER
(F)

(G)

(H)

(I)

(J)

(K)

1.0000

3,613.00

0.0590

213

0.00

1.0000

27,540.00

0.0590

1,625

0.00

6,461

1.0000

6,461.00

0.0590

381

0.00

12B/12B
Addendum

55

1.0000

55.00

0.0380

2

0.00

Work Initiation Document for Wildlife Damage
Management (Multiple Resource Owners) (Private
Sector)

12B/12B
Addendum

427

1.0000

427.00

0.0380

16

0.00

426; 426b

Work Initiation Document for Wildlife Damage
Management (Multiple Resource Owners) (State,
Local or Tribal Group)

12B/12B
Addendum

99

1.0000

99.00

0.0380

4

0.00

426; 426b

Work Initiation Document for Wildlife Damage
Management on Urban Properties (Indivual)

12C

1,358

1.0000

1,358.00

0.0210

29

0.00

426; 426b

Work Initiation Document for Wildlife Damage
Management on Urban Properties (Private Sector)

12C

10,357

1.0000

10,357.00

0.0210

217

0.00

426; 426b

Work Initiation Document for Wildlife Damage
Management on Urban Properties (State, Local or
Tribal Group)

12C

2,432

1.0000

2,432.00

0.0210

51

0.00

426b; 426c

Pocatello Supply Depot Order Form (Individual)

17

77

1.0000

77.00

0.0650

5

0.00

426; 426b

SUBTOTAL

3,613

27,540

52,419

52,419.00

2,543

0

0.00

TOTAL OF ALL PAGES

117,772

5,448

0.00

0.00

TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b;
COLUMNS "H" AND "K" = OMB 831, 13c

117,772

5,448

SUMMARY OF INFORMATION COLLECTION
APHIS FORM 71
(AUG 2005) Electronic versions designed using InForms
and Microsoft Excel by USDA-APHIS.

USDA-APHIS

REPRODUCE LOCALLY. Include form number and date on all reproductions.

Page 2 of 4

SUMMARY OF INFORMATION COLLECTION

INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and
recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1:
cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b;
cols. H & K = 13c.
(F)Total/(D)Total = (E)Average

TITLE OF INFORMATION COLLECTION DOCUMENT

OMB NO.

National Management Information System - pg 2 of 4

0579-0335

(H)Total/(F)Total = (G)Average

DATE PREPARED

(K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6
years, list as "1/6" & decimal will display.

August 9, 2012
ANNUAL BURDEN

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT

REPORTS

RECORDS
TOTAL

SECTION OF

FORMS NO (S)

NO. OF

NO OF

TOTAL ANNUAL

(If "none"

RESPONDENTS

RESPONSES

RESPONSES

PER

PER

(Col. D x E)

RESPONSE

DESCRIPTION

REGS.

so state)

HOURS

TOTAL

NO. OF

ANNUAL

RECORD-

HOURS

RECORD-

HOURS PER

KEEPING HOURS

(Col. F x G)

KEEPERS

RECORD-

(Col. I x J)

RESPONDENT
(A)

(B)

(C)

(D)

(E)

KEEPER
(F)

(G)

(H)

(I)

(J)

(K)

426b; 426c

Pocatello Supply Depot Order Form (Private Sector) 17

592

1.0000

592.00

0.0650

38

0.00

426b; 426c

Pocatello Supply Depot Order Form (State, Local or
17
Tribal Group)

138

1.0000

138.00

0.0650

9

0.00

426; 426b

Project Report (Individual)

14

24

1.0000

24.00

0.0440

1

0.00

426; 426b

Project Report (Private Sector)

14

173

1.0000

173.00

0.0440

8

0.00

426; 426b

Project Report (State, Local or Tribal Group)

14

39

1.0000

39.00

0.0440

2

0.00

426b

Control Materials Sales Records (Individual)

18

49

1.0000

49.00

0.0630

3

0.00

426b

Control Materials Sales Records (Private Sector)

18

365

1.0000

365.00

0.0630

23

0.00

426b

Control Materials Sales Records (State, Local or
Tribal Group)

18

77

1.0000

77.00

0.0630

5

0.00

426; 426b

Wildlife Services Assistance Request
(Individual)

30

21,738

1.0000

21,738.00

0.0350

761

0.00

426; 426b

Wildlife Services Assistance Request (Private
Sector)

30

28,013

1.0000

28,013.00

0.0350

980

0.00

426; 426b

Wildlife Services Assistance Request (State,
Local or Tribal Group)

30

8,003

1.0000

8,003.00

0.0350

280

0.00

SUBTOTAL

59,211

SUMMARY OF INFORMATION COLLECTION
APHIS FORM 71
(AUG 2005) Electronic versions designed using InForms
and Microsoft Excel by USDA-APHIS.

59,211

2,110

0

0

USDA-APHIS

REPRODUCE LOCALLY. Include form number and date on all reproductions.

Page 3 of 4

SUMMARY OF INFORMATION COLLECTION

INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and
recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1:
cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b;
cols. H & K = 13c.
(F)Total/(D)Total = (E)Average

TITLE OF INFORMATION COLLECTION DOCUMENT

OMB NO.

National Management Information System pg. 3 of 4

0579-0335

(H)Total/(F)Total = (G)Average

DATE PREPARED

(K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6
years, list as "1/6" & decimal will display.

August 9, 2012
ANNUAL BURDEN

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT

REPORTS

RECORDS
TOTAL

SECTION OF

FORMS NO (S)

NO. OF

NO OF

TOTAL ANNUAL

(If "none"

RESPONDENTS

RESPONSES

RESPONSES

PER

PER

(Col. D x E)

RESPONSE

DESCRIPTION

REGS.

so state)

HOURS

TOTAL

NO. OF

ANNUAL

RECORD-

HOURS

RECORD-

HOURS PER

KEEPING HOURS

(Col. F x G)

KEEPERS

RECORD-

(Col. I x J)

RESPONDENT
(A)

(B)

(C)

(D)

(E)

KEEPER
(F)

(G)

(H)

(I)

(J)

(K)

426b; 522a

WS Resource Values Survey (Private Sector)

45

52

1.0000

52.00

0.0530

3

0.00

426; 426b

Report of Injury or Death to Non-target Animals
35
(Private Sector)

1

1.0000

1.00

0.3800

1

0.00

426; 426b

Migratory Bird Damage Project Report
(Individual)

37

579

1.0000

579.00

0.1300

75

0.00

426; 426b

Migratory Bird Damage Project Report (Private
37
Sector)

4,410

1.0000

4,410.00

0.1300

573

0.00

426; 426b

Migratory Bird Damage Project Report (State,
Local or Tribal Group)

37

1,034

1.0000

1,034.00

0.1300

134

0.00

426

Nuisance Wildlife Permit (Louisiana)
(Individual)

66

6

1.0000

6.00

0.0610

1

0.00

426

Nuisance Wildlife Permit (Louisiana) (Private
Sector)

66

46

1.0000

46.00

0.0610

3

0.00

426

Nuisance Wildlife Permit (Louisiana) (State,
Local or Tribal Group)

66

10

1.0000

10.00

0.0610

1

0.00

426; 426b

Wildlife Services Abatement Program
Assignment of U.S. Government Property
(Private Sector)

68

0

1.0000

0.00

0.0195

0

0.00

Cleared under 4040-0005 (Common Form)

SF 424

4

1.0000

4.00

0.7500

3.00

0.00

SUBTOTAL

6,142
SUMMARY OF INFORMATION COLLECTION

APHIS FORM 71
(AUG 2005) Electronic versions designed using InForms
and Microsoft Excel by USDA-APHIS.

6,142

795

0

0
USDA-APHIS

REPRODUCE LOCALLY. Include form number and date on all reproductions.

Page 4 of 4

SUMMARY OF INFORMATION COLLECTION

INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and
recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1:
cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b;
cols. H & K = 13c.

TITLE OF INFORMATION COLLECTION DOCUMENT

OMB NO.

National Management Information System pg. 4 of 4

0579-0335

(F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average
(K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6
years, list as "1/6" & decimal will display.

DATE PREPARED

August 9, 2012
ANNUAL BURDEN

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT

REPORTS

RECORDS
TOTAL

SECTION OF

DESCRIPTION

REGS.

FORMS NO (S)

NO. OF

NO OF

TOTAL ANNUAL

(If "none"

RESPONDENTS

RESPONSES

RESPONSES

PER

PER

(Col. D x E)

RESPONSE

so state)

HOURS

TOTAL

NO. OF

ANNUAL

RECORD-

HOURS

RECORD-

HOURS PER

KEEPING HOURS

(Col. F x G)

KEEPERS

RECORD-

(Col. I x J)

RESPONDENT
(A)

(B)

(C)

(D)

(E)

KEEPER
(F)

(G)

Cooperative Agreement Forms Family
**
These figures were not added to the total

SF 424,
424A, 424b,
SF LLL

Cleared under 0348-0044

SF 424a

4

1.0000

4.00

Cleared under 0348-0040

SF 424B

4

1.0000

Cleared under 0348-0046

SF LLL

0

1.0000

SUBTOTAL

0.00

0

SUMMARY OF INFORMATION COLLECTION
APHIS FORM 71
(AUG 2005) Electronic versions designed using InForms
and Microsoft Excel by USDA-APHIS.

(H)

(I)

(J)

(K)

0.00

0.00

3.0000

12.00

0.00

4.00

0.2500

1.00

0.00

0.00

0.5000

0.00

0.00

0.00

0.00

USDA-APHIS