U.S. Origin Health Certificate

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0579-0020 can be found here:

Documents and Forms

Document Name Document Type
Form VS 17-140 U.S. Origin Health Certificate Form
VS 17-140 United States Origin Health Certificate VS 17-140 SEP 2010.pdf Form
VS 17-140A United States Origin Health Certificate - Continuation S VS 17-140a Apr 2003.pdf Form
VS 17-140B Continuation Sheet for United States Orgin Health Certif VS 17-140b JAN 2011.pdf Form
VS 17-145 UNITED STATES ORIGIN HEALTH CERTIFICATE FOR THE EXPORT O VS 17-145 DEC 2010.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	U.S. Origin Health Certificate	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 9 CFR 92 9 CFR 91

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	VS 17-140	United States Origin Health Certificate	VS 17-140 SEP 2010.pdf	No	Paper Only
Form	VS 17-140A	United States Origin Health Certificate - Continuation Sheet	VS 17-140a Apr 2003.pdf	No	Paper Only
Form	VS 17-140B	Continuation Sheet for United States Orgin Health Certificate	VS 17-140b JAN 2011.pdf	No	Paper Only
Form	VS 17-145	UNITED STATES ORIGIN HEALTH CERTIFICATE FOR THE EXPORT OF HORSES FROM THE UNITED STATES TO CANADA	VS 17-145 DEC 2010.pdf	No	Paper Only

Line of Business: Natural Resources

Subfunction: Agricultural Innovation and Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,393	Number of Respondents for Small Entity: 205

Affected Public: Private Sector	Private Sector: Farms, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 10 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	72,755	1	72,754
Annual IC Time Burden (Hours)	17,611	1	17,610
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.