Information Collection

Report of Identification of a Select Agent or Toxin (APHIS/CDC Form 4) - Guidance

IC 227783 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Report of Identification of a Select Agent or Toxin (APHIS/CDC Form 4) - Guidance Form and Instruction
Guidance Document for the completion of APHIS/CDC Form 4 Att7i-Form4Guide.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Report of Identification of a Select Agent or Toxin (APHIS/CDC Form 4) - Guidance	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection 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 4	Att7i-Form4Guide.pdf	NA	Yes	No	Printable Only

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: 1,030	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 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,030	1,030
Annual IC Time Burden (Hours)	515	515
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.