Information Collection

U.S. Origin Health Certificate

IC 2093 under ICR 201307-0579-001 · OMB 0579-0020.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

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.