Information Collection

NAHMS Emergency Highly Pathogenic Avian Influenza Epidemiologic Investigation

IC 216037 under ICR 201403-0579-005 · OMB 0579-0376.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0579-0376 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VS 17-5 NAHMS Emergency Highly Pathogenic Avian Influenza Epidemiologic Investigation	Form
VS 17-5 Highly Pathogenic Avian Influenza (HPAI) Investigation - VS 17-5 APR 2015.pdf	Form
HPAI EEI 2015 Part B.docx Part B of the Supporting Statement	IC Document
HPAI 2015 APHIS 71.xls APHIS 71	IC Document
HPAI 2015 APHIS 79.xlsx APHIS 79	IC Document
HPAI EEI 2015 Part A.doc Part A of the Supporting Statement	IC Document

IC Title:

NAHMS Emergency Highly Pathogenic Avian Influenza Epidemiologic Investigation

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 9 CFR 1-199 (To search for a specific CFR, visit the Code of Federal Regulations.)

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	VS 17-5	Highly Pathogenic Avian Influenza (HPAI) Investigation - Questionaire	VS 17-5 APR 2015.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: 180

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

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	180	180
Annual IC Time Burden (Hours)	181	181
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Part B of the Supporting Statement	HPAI EEI 2015 Part B.docx	04/23/2015
APHIS 71	HPAI 2015 APHIS 71.xls	04/23/2015
APHIS 79	HPAI 2015 APHIS 79.xlsx	04/23/2015
Part A of the Supporting Statement	HPAI EEI 2015 Part A.doc	04/24/2015

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.