U.S. Origin Health Certificate

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form VS 17-140 U.S. Origin Health Certificate	Form and Instruction	Modified	Available
0020 ss 20170731.pdf	Supporting Statement A	Uploaded 2017-07-31	Available
0020_79_20170717.pdf	Supplementary Document	Uploaded 2017-07-17	Available
0020_APHIS 71_20170717.pdf	Supplementary Document	Uploaded 2017-07-17	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
2093	U.S. Origin Health Certificate	Form and Instruction	Modified

ICR Details

OMB Control No: 0579-0020	ICR Reference No: 201707-0579-003
Status: Active	Previous ICR Reference No: 201307-0579-001
Agency/Subagency: USDA/APHIS	Agency Tracking No:
Title: U.S. Origin Health Certificate
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/15/2017
	Date Received in OIRA: 07/31/2017
Terms of Clearance: Before this ICR is renewed, USDA should consider converting VS Form 17-140, VS From 17-140A, and APHIS Form 7001 to common forms.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2020	36 Months From Approved	11/30/2017
Responses	35,761	0	72,755
Time Burden (Hours)	17,170	0	17,611
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this information collection is to gather information on animals exported from the U.S. thereby preventing the international dissemination of animal disease.

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Authorizing Statute(s): US Code: 7 USC 8301 Name of Law: Animal Health Protection Act of 2002
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 24275	05/26/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 35507	07/31/2017
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
U.S. Origin Health Certificate	VS 17-140, VS Form 17-104A, VS Form 17-140B, APHIS Form 7001, VS 17-141, VS Form 17-145	United States Origin Health Certificate ,   Continuation Sheet for United States Origin Health Certificate ,   Continuation Sheet for U.S. Origin Health Certificate ,   United States Origin Health Certificate for the Export of Horses from the U.S. to Canada ,   United States Interstate and International Certificate of Health Examination for Small Animals ,   Health Certificate for the Export of Live Finfish, Mollusks, and Crustaceans (and Their Gametes)

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	35,761	72,755	0	-41,368	4,374	0
Annual Time Burden (Hours)	17,170	17,611	0	-2,631	2,190	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Overall, the total burden hours decreased 441 hours (-2,631 program change and +2,190 adjustment) and the total number of responses decreased 36,994 responses (-41,368 program change and +4,374 adjustment). The decrease resulted from removing Recordkeeping for Modification, which is no longer codified or practiced (-45,000 responses; -3,735 hours) (program change). The following items were previously approved under 0579-0278 (discontinued) and have been added to this information collection for approval (program change/violation): • VS Form 17-141(+100 responses; +26 hours). • APHIS Form 7001 (+750 responses; + 98 hours). • Country Specific Health Care (+1,800 responses; + 450 hours). • Travel Time (+256 responses; + 256 hours). The following items were inadvertently not included in previous information collection submissions and have been added to this information collection for approval (program change/violation): • Annual Site Inspection of Inspection Facilities (+38 responses; +76 hours). • Certification to Carry Livestock (+8 responses; + 20 hours). • Inspection of Vessel Prior to Voyage (+ 10 responses; + 10 hours). • Aircraft Cleaning and Disinfection (+670 responses; + 168 hours). The burden of the following items has increased since the last submission of this information collection to more accurately reflect current use (adjustment): • VS Form 17-140 (+ 1,368 responses; + 684 hours). • VS Forms 17-140A and 17-140B (+ 3,000 responses; +1,500 hours). • Notarized Statement (+ 6 responses; +6 hours).

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Annual Cost to Federal Government: $10,137,274

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/31/2017

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