Information Collection

Att 4C_Federal Law Enforcement Reporting Seizure of Select Agent of Toxin (APHIS/CDC) Form 4C

IC 227782 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⚠️ Notice: This information collection may be referencing outdated material.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
Att 4C_Federal Law Enforcement Reporting Seizure of Select Agent of Toxin (APHIS/CDC) Form 4C	Form and Instruction
Reporting the Identification of a Select Agent or Toxin: Att7c-Form4C.PDF	Form and Instruction
APHIS/CDC FORM 4C Reporting the Identification of a Select Agent or Toxin: Att4C-Rept the ID of Select Agent fromFederal Law Enfor....pdf www.selectagents.gov/form4.html	Form and Instruction

IC Title:

Att 4C_Federal Law Enforcement Reporting Seizure of Select Agent of Toxin (APHIS/CDC) Form 4C

Agency IC Tracking Number:

0920-0576 18FL

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 and Instruction	NA	Reporting the Identification of a Select Agent or Toxin: Federal Law Enforcement Seizure Report (APHIS/CDC Form 4C)	Att7c-Form4C.PDF	NA	Yes	Yes	Fillable Fileable
Form and Instruction	APHIS/CDC FORM 4C	Reporting the Identification of a Select Agent or Toxin: Federal Law Enforcement Seizure Report	Att4C-Rept the ID of Select Agent fromFederal Law Enfor....pdf	http://www.selectagents.gov/form4.html	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

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 4883

Number of Respondents: 1

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	1	1
Annual IC Time Burden (Hours)	1	1
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.