Information Collection

Business

IC 215446 under ICR 201601-0579-004 · OMB 0579-0432.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VS 17-140 Business	Form and Instruction
VS 17-140 U.S. Origin Health Certificate VS 17-140 NOV 2014.pdf	Form and Instruction
VS 17-140A Continuation Sheet for United States Origin Health Certi VS 17-140A JAN 2011 new.pdf	Form

IC Title:

Business

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 9 CFR 91

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 and Instruction	VS 17-140	U.S. Origin Health Certificate	VS 17-140 NOV 2014.pdf		No		Paper Only
Form	VS 17-140A	Continuation Sheet for United States Origin Health Certificate	VS 17-140A JAN 2011 new.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: 10,183

Number of Respondents for Small Entity: 1,018

Affected Public: Private Sector

Private Sector: Farms, 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	29,614	29,614
Annual IC Time Burden (Hours)	15,950	15,950
Annual IC Cost Burden (Dollars)	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.