U.S. Origin Health Certificate

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form VS 17-140 U.S. Origin Health Certificate	Form	Modified	Available
2013 ss.doc	Supporting Statement A	Uploaded 2014-04-28	Available
2013 79.xls	Supplementary Document	Uploaded 2014-04-09	Available
2013 71.xls	Supplementary Document	Uploaded 2014-04-09	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
2093	U.S. Origin Health Certificate	Form	Modified

ICR Details

OMB Control No: 0579-0020	ICR Reference No: 201307-0579-001
Status: Historical Active	Previous ICR Reference No: 201010-0579-013
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 without change	Conclusion Date: 07/03/2014
	Date Received in OIRA: 04/28/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2017	36 Months From Approved	07/31/2014
Responses	72,755	0	72,754
Time Burden (Hours)	17,611	0	17,610
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 U.S. 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:
	79 FR 12	01/17/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 78	04/23/2014
Did the Agency receive public comments on this ICR? Yes

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

table that charts list of burden

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 ,   UNITED STATES ORIGIN HEALTH CERTIFICATE FOR THE EXPORT OF HORSES FROM THE UNITED STATES TO CANADA

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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	72,755	72,754	0	1	0	0
Annual Time Burden (Hours)	17,611	17,610	0	1	0	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 total burden hours increased 1 hour and the total number of responses increased by 1 response due to adding 1 response to the Notarized Statement burden item as a placeholder. APHIS still hasn't received a response even though it is offered and is in the regulations. In the last submission, APHIS had a zero. In addition, the number of respondents decreased from 2,056 to 1,393 due to double-counting in previous submissions (no actual change in the burden).

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Annual Cost to Federal Government: $1,135,031

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: 04/28/2014

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