Information Collection

Report of Identification of a Select Agent or Toxin from a Proficiency Test

IC 227499 under ICR 201804-0920-015 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Form APHIS/CDC FORM 4B Report of Identification of a Select Agent or Toxin from a Proficiency Test	Form and Instruction
REPORTING THE IDENTIFICATION OF A SELECT AGENT OR TOXIN Att7b-Form4B.PDF	Form and Instruction
APHIS/CDC FORM 4B REPORTING THE IDENTIFICATION OF A SELECT AGENT OR TOXIN: Att4B-Rept the ID of Select Agent from Proficiency Test....pdf www.selectagents.gov/form4.html	Form and Instruction

IC Title:

Report of Identification of a Select Agent or Toxin from a Proficiency Test

Agency IC Tracking Number:

0920-0576 18FL

Is this a Common Form? No

IC Status: Unchanged

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	APHIS/CDC FORM 4B	REPORTING THE IDENTIFICATION OF A SELECT AGENT OR TOXIN: PROFICIENCY TESTING REPORT	Att4B-Rept the ID of Select Agent from Proficiency Test....pdf	http://www.selectagents.gov/form4.html	Yes	Yes	Fillable Fileable
Form and Instruction	NA	REPORTING THE IDENTIFICATION OF A SELECT AGENT OR TOXIN FROM A PROFICIENCY TEST (APHIS/CDC FORM 4B)	Att7b-Form4B.PDF	NA	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 4483

Number of Respondents: 10

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: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	5	5
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.