USDA-APHIS-Animal Care Online Compliant - Individuals

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery - APHIS

AC compliant process

USDA-APHIS-Animal Care Online Compliant - Individuals

OMB: 0579-0377

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USDA, APHIS, Animal Care
ANIMAL WELFARE COMPLAINT

To report a concern about an animal covered under the Animal Welfare Act or the Horse Protection Act, please complete the form below.


Details of complaint:


 


In the box below, please give a detailed description of your concern. The types of information that would be helpful to us include: the date of the incident; the type(s) of animal(s) present; the behavior of the animal(s); the condition of the animal(s); the condition of the facility; the actions of the person with the animals; the location of the incident; etc.


 


Name of USDA licensee/registrant
(if known)

USDA license/registration number
(if known)


 


City (required)

State (required)


 


Your contact information:



You can choose to remain anonymous; however, providing this information will give USDA Animal Care a way to contact you if we need additional information.


Name

Organization


 


Street address

Apt/Suite


 


City

State


 


Zip

Phone number


 


Email:


 


Thank you for your interest in the welfare of animals that are covered by the Animal Welfare Act and the Horse Protection Act. We will look into your concerns as soon as possible. If you would like to know the outcome of your complaint, please make a Freedom of Information Act (FOIA) request.




According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0579-0377. The time required to complete this information collection is estimated to average .5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

OMB APPROVED
0579-0377
EXP. DATE
8/2015




File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorHardy, Kimberly A - APHIS
File Modified0000-00-00
File Created2021-01-24

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