Information Collection

Notification of Theft, Loss or Release

IC 186022 under ICR 201406-0920-016 · OMB 0920-0576.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0576 can be found here:

Documents and Forms

Document Name Document Type
Notification of Theft, Loss or Release Form
Report of Theft, Loss or Release of Select Agents and To APHIS-CDC Form 3 Notification of Theft Loss or Release_clean version.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Notification of Theft, Loss or Release	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 73(19) (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Report of Theft, Loss or Release of Select Agents and Toxins (APHIS/CDC Form 3)	APHIS-CDC Form 3 Notification of Theft Loss or Release_clean version.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title: National Select Agent Registry (NSAR) Select Agent Transfer and Entity Registration Information System (SATERIS), HHS/CDC/COPTER	FR Citation: 76 FR 4483

Number of Respondents: 180	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Previously Approved
Annual Number of Responses for this IC	180	180
Annual IC Time Burden (Hours)	180	180
Annual IC Cost Burden (Dollars)	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.