Information Collection

Application for Registration

IC 217508 under ICR 201701-0920-008 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Application for Registration	Form
Application for Registration Attachment 8 - Application for Registration.docx	Form
APHIS-CDC_Form_1_Attachment_A.pdf Drop down list	IC Document
APHIS-CDC_Form_1_Attachment_B-112316.pdf Drop down list	IC Document
APHIS-CDC_Form_1_Attachment_D-112316.pdf Drop down list	IC Document
APHIS-CDC_Form_1_Section_1A_1B.pdf Drop down list	IC Document
APHIS-CDC_Form_1_Section_3-112916.pdf Drop down list	IC Document
APHIS-CDC_Form_1_Section_7B-112316.pdf Drop down list	IC Document
APHIS-CDC_Form_1_Section_7C-112316.pdf Drop down list	IC Document
APHIS-CDC_Form_1_Sec 7A_edits 01192017.pdf Form 1 Section 7A	IC Document
APHIS-CDC_Form_1_Sec 6A_edits 01192017.pdf Form 1 Section 6A	IC Document
APHIS-CDC_Form_1_Att C_edits 01192017.pdf Attachment C Work with Animals	IC Document
APHIS-CDC_Form_1_Att E_edits 01192017.pdf Attachment E Work with Arthropods	IC Document
APHIS-CDC Form 1 Att F_edits 01192017.pdf Attachment F BSL3Ag Laboratories	IC Document

IC Title:

Application for Registration

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.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Application for Registration	Attachment 8 - Application for Registration.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title: 09-20-0170 National Select Agent Registry/Select Agent Transfer and Entity Registration Information System

FR Citation: 76 FR 4483

Number of Respondents: 5

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	5	5
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Drop down list	APHIS-CDC_Form_1_Attachment_A.pdf	12/01/2016
Drop down list	APHIS-CDC_Form_1_Attachment_B-112316.pdf	12/01/2016
Drop down list	APHIS-CDC_Form_1_Attachment_D-112316.pdf	12/01/2016
Drop down list	APHIS-CDC_Form_1_Section_1A_1B.pdf	12/01/2016
Drop down list	APHIS-CDC_Form_1_Section_3-112916.pdf	12/01/2016
Drop down list	APHIS-CDC_Form_1_Section_7B-112316.pdf	12/01/2016
Drop down list	APHIS-CDC_Form_1_Section_7C-112316.pdf	12/01/2016
Form 1 Section 7A	APHIS-CDC_Form_1_Sec 7A_edits 01192017.pdf	01/26/2017
Form 1 Section 6A	APHIS-CDC_Form_1_Sec 6A_edits 01192017.pdf	01/26/2017
Attachment C Work with Animals	APHIS-CDC_Form_1_Att C_edits 01192017.pdf	01/26/2017
Attachment E Work with Arthropods	APHIS-CDC_Form_1_Att E_edits 01192017.pdf	01/26/2017
Attachment F BSL3Ag Laboratories	APHIS-CDC Form 1 Att F_edits 01192017.pdf	01/26/2017

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