Download:
pdf |
pdfINSTRUCTIONS: Use this form when a single information collection document involves multiple reporting
TITLE OF INFORMATION COLLECTION DOCUMENT
and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1:
U.S. Origin Health Certificate
cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b;
cols. H & K = 13c.
(F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6
years, list as "1/6" & decimal will display.
OMB NO.
0579-0020
DATE PREPARED
ANNUAL BURDEN
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
REPORTS
RECORDS
TOTAL
SECTION OF
REGS.
DESCRIPTION
(A)
(B)
FORMS NO (S)
NO. OF
NO OF
(If "none"
RESPONDENTS RESPONSES
so state)
PER
TOTAL ANNUAL
RESPONSES
(Col. D x E)
HOURS
PER
RESPONSE
TOTAL
HOURS
(Col. F x G)
NO. OF
RECORDKEEPERS
(F)
(G)
(H)
(I)
RESPONDENT
91.3
91.3
(C)
U.S. Origin Health Certificate - Businesses
VS 17-140
Farms
VS 17U.S. Origin Health Certificate (Continuation) 140A, VS
Businesses
17-140B
Farms
91.3
U.S. Origin Health Certificate for the Export of
Horses from the U.S. to Canada - Businesses
91.7
Undue Hardship - Businesses
Farms
91.10
91.10
91.10
Farms
Application for Approval of Inspection Facility Environmental Certification - Businesses
Annual Site Inspection of Inspection Facilities Businesses
Opportunity to Present Views Concerning
Withdrawal of Facility Approval - Businesses
VS 17-145
(D)
(E)
ANNUAL
RECORDHOURS PER KEEPING HOURS
RECORD(Col. I x J)
KEEPER
(J)
(K)
600
184
20.00 12,000.00
2.00
368.00
0.50
0.50
6,000.00
184.00
0.00
0.00
555
20.00 11,100.00
0.50
5,550.00
0.00
50
15.00
750.00
0.50
375.00
0.00
500
15.00
7,500.00
0.50
3,750.00
0.00
120
10
1
3.00
3.00
1.00
360.00
30.00
1.00
0.50
0.50
0.50
180.00
15.00
1.00
0.00
0.00
0.00
10
1.00
10.00
0.20
2.00
0.00
38
1.00
38.00
2.00
76.00
0.00
3
1.00
3.00
0.50
2.00
0.00
SUBTOTAL
32,160.00
16,135.00
0.00
0.00
TOTAL OF ALL PAGES
35,761
17,170
0.00
0.00
TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b;
COLUMNS "H" AND "K" = OMB 831, 13c
35,761
17,170
INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting
TITLE OF INFORMATION COLLECTION DOCUMENT
and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1:
U.S. Origin Health Certificate
cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b;
cols. H & K = 13c.
(F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6
years, list as "1/6" & decimal will display.
OMB NO.
0579-0020
DATE PREPARED
ANNUAL BURDEN
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
REPORTS
RECORDS
TOTAL
FORMS NO (S)
SECTION OF
DESCRIPTION
(If "none"
NO. OF
NO OF
RESPONDENTS RESPONSES
so state)
REGS.
PER
TOTAL ANNUAL
HOURS
TOTAL
NO. OF
RESPONSES
PER
HOURS
RECORD-
(Col. D x E)
RESPONSE
(Col. F x G)
KEEPERS
ANNUAL
HOURS PER KEEPING HOURS
RECORD-
RESPONDENT
(A)
91.12
91.12
91.12
91.13
91.3
91.3
91.3
91.3
91.3
91.3
91
91
(B)
(C)
Certification to Carry Livestock - Businesses
Inspection of Vessel Prior to Voyage Businesses
Notarized Statement - Businesses
Aircraft Cleaning and Disinfection - Businesses
Health Certificate for Export of Live
Crustaceans, Finfish, Mollusks, and GametsVS 17-141
(Exporters) Businesses
(Accredited Veterinarians) - Businesses
United States Interstate and International
Certificate of Health Examination for Small
Animals (Exporters) - Businesses
(Accredited Veterinarians) - Businesses
Country Specific Health Care (Exporters) Businesses
(Accredited Veterinarians) - Businesses
Travel Time (Exporters) - Businesses
Travel Time (Accredited Veterinarians) Businesses
SUBTOTAL
APHIS
7001
(D)
(E)
RECORD-
(Col. I x J)
KEEPER
(F)
(G)
(H)
(I)
(J)
(K)
8
1.00
8.00
2.50
20.00
0.00
10
1.00
10.00
1.00
10.00
0.00
7
1.00
7.00
1.00
7.00
0.00
670
1.00
670.00
0.25
168.00
0.00
5
10.00
50.00
0.25
13.00
0.00
5
10.00
50.00
0.25
13.00
0.00
15
25.00
375.00
0.13
49.00
0.00
15
25.00
375.00
0.13
49.00
0.00
25
36.00
900.00
0.25
225.00
0.00
25
36.00
900.00
0.25
225.00
0.00
32
4.00
128.00
1.00
128.00
0.00
32
4.00
128.00
1.00
128.00
0.00
3,601.00
1,035.00
0
0.00
| File Type | application/pdf |
| Author | cquatrano |
| File Modified | 2017-07-17 |
| File Created | 2017-07-17 |