Information Collection

Report of Theft, Loss or Release of Select Agent or Toxin (APHIS/CDC Form 3) - Guidance

IC 227779 under ICR 201712-0920-006 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Report of Theft, Loss or Release of Select Agent or Toxin (APHIS/CDC Form 3) - Guidance	Form and Instruction
Guidance Document for the completion of APHIS/CDC Form 3 Att4a-Form3Guide.docx	Form and Instruction

IC Title:

Report of Theft, Loss or Release of Select Agent or Toxin (APHIS/CDC Form 3) - Guidance

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

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 and Instruction	NA	Guidance Document for the completion of APHIS/CDC Form 3	Att4a-Form3Guide.docx	NA	Yes	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title: RISC and OIRA Consolidated Information System

FR Citation: 76 FR 4483

Number of Respondents: 205

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	205	205
Annual IC Time Burden (Hours)	103	103
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.