Information Collection

Public Health Information System

IC 196167 under ICR 201504-0583-001 · OMB 0583-0153.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0583-0153 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5200-6 Application/Approval for Voluntary Inspection Public Health Information System	Form
Form 5200-15 Hours of Operations Public Health Information System	Form
Form 9080-4 Meat, Poultry, and Egg Product List Public Health Information System	Form
Form 9080-3 Establishment Application for Export Public Health Information System	Form and Instruction
Form 9060-6 Application for Export Certificate Public Health Information System	Form
Form FSIS 9010-1 Application for the Return of Exported Products to the United States Public Health Information System	Form and Instruction
Form 5200-2 Application for Federal Inspection Public Health Information System	Form and Instruction
Transfer certificate with OMB.docx	Other-screens-Transfer Certificate
9080-4 product list screen shots OMB statement March 1 2011.docx	Other-screens-Product List
PHIS Sscreen shots 9010-1 030211.pdf	Other-screens-Application for Return
9010-1 Application for Return of Exported Goods.pdf	Other-screen shots
9080-3 Establishment Application for Export.pdf	Other-screen shots
9060-6 Application for Export of Goods In Lieu of Consolidated Split.pdf	Other-screen shots
9060-6 Application for Export of Goods.pdf	Other-screen shots
5200-6 Application/Approval for Voluntary Inspection FSIS 5200-6.pdf	Form
5200-15 Hours of Operations FSIS 5200-15 Hours of Operation Request Approval .pdf	Form
9080-4 Meat, Poultry, and Egg Product List FSIS 9080-4.pdf	Form
9080-3 Establishment Application for Export FSIS 9080-3 ESTABLISHMENT APPLICATION FOR EXPORT OF _v8508.pdf	Form and Instruction
9060-6 Application for Export Certificate FSIS 9060-6 .pdf	Form
FSIS 9010-1 Application for the Return of Exported Products to the U FSIS 9010-1 Application for the Return of Exported Products to the United States_v8RE508.pdf	Form and Instruction
5200-2 Application for Federal Inspection FSIS FORM 5200-2 - APPLICATION FOR FEDERAL INSPECTION (04-09-2015).pdf	Form and Instruction
Summary of the changes from the current FSIS Form 5200.docx summary of changes to FSIS Form 5200-2	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Public Health Information System

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5200-6	Yes	Yes	Fillable Fileable
Form	5200-15	Yes	Yes	Fillable Fileable
Other-screens-Transfer Certificate		Yes	Yes	Fillable Fileable
Form	9080-4	Yes	No	Fillable Printable
Other-screens-Product List		Yes	Yes	Fillable Fileable
Form and Instruction	9080-3	Yes	No	Fillable Printable
Form	9060-6	Yes	No	Fillable Printable
Other-screens-Application for Return of Exported Product		Yes	Yes	Fillable Fileable
Form and Instruction	FSIS 9010-1	Yes	No	Fillable Printable
Other-screen shots		Yes	Yes	Fillable Fileable
Other-screen shots		Yes	Yes	Fillable Fileable
Other-screen shots		Yes	Yes	Fillable Fileable
Other-screen shots		Yes	Yes	Fillable Fileable
Form and Instruction	5200-2	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,067

Number of Respondents for Small Entity: 2,750

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	865,480	865,480
Annual IC Time Burden (Hours)	145,481	145,481
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
summary of changes to FSIS Form 5200-2		04/23/2015

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

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