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APHIS 71

ICR 201808-0579-003 · OMB 0579-0065 · Object 85220101.

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application/vnd.openxmlformats-officedocument.spreadsheetml.sheet
APHIS 71
cquatrano
Calc
2017-05-31
2026-09-13
complete

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INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting
and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1:
cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b;
cols. H & K = 13c.

TITLE OF INFORMATION COLLECTION DOCUMENT

OMB NO.

Swine Health Protection

0579-0065

(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.

DATE PREPARED

February 13, 2017
ANNUAL BURDEN

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT

REPORTS

RECORDS
TOTAL

SECTION OF
REGS.

FORMS NO
(S)
NO. OF
NO OF
(If "none" RESPONDENTS RESPONSES
so state)
PER

DESCRIPTION

TOTAL ANNUAL
RESPONSES
(Col. D x E)

HOURS
PER
RESPONSE

TOTAL
HOURS
(Col. F x G)

NO. OF
RECORDKEEPERS

RESPONDENT
(A)

116.2

(B)

(C)

Food Waste Report

(D)

(E)

ANNUAL
HOURS PER
RECORD-

RECORDKEEPING HOURS

(Col. I x J)

KEEPER
(F)

(G)

(H)

(I)

(J)

VS 13-17

(K)

0

Business

50

1

50

0.08

4

0

State

50

1

50

0.08

4

0

116.10, 12

Application for Licensing of Garbage Treatment
VS 13-15
Facility (Business)

106

1

106

0.16

17

0

116.1(b)

Acknowledgement of Act and Regulations
(Business)

106

1

106

0.25

27

0

116.13

Garbage Treatment Facility Inspection

VS 13-16

0

Business

1,410

5

7,050

1.00

7,050

0

State

50

70

3,500

1.00

3,500

0

1

1

1

1.00

1

0

166.10, 11, 12

Request for Hearing (Business)

166.12

Cancellation of License by Licensee or State

0

Business

4

1

4

0.25

1

0

State

2

1

2

0.25

1

0

SUBTOTAL

10,869

10,605

0.00

0

TOTAL OF ALL PAGES

1,101,204

1,672,131

46,585.00

15518

TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b;
COLUMNS "H" AND "K" = OMB 831, 13c

15,000

1,147,789

1,687,650

\

INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting
and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1:
cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b;
cols. H & K = 13c.

TITLE OF INFORMATION COLLECTION DOCUMENT

OMB NO.

Swine Health Protection

0579-0065

(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.

DATE PREPARED

February 13, 2017
ANNUAL BURDEN

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT

REPORTS

RECORDS
TOTAL

FORMS NO
(S)
SECTION OF

DESCRIPTION

(If "none"

REGS.

NO. OF

NO OF

RESPONDENTS RESPONSES

so state)

PER

TOTAL ANNUAL

HOURS

TOTAL

NO. OF

ANNUAL

RECORD-

RESPONSES

PER

HOURS

RECORD-

HOURS PER

KEEPING HOURS

(Col. D x E)

RESPONSE

(Col. F x G)

KEEPERS

RECORD-

(Col. I x J)

RESPONDENT
(A)

(B)

(C)

166.13

Notification by Licensee of Sick or Dead
Animals (Business)

166.15

Swine Health Protection Program Inspection
Summary (State)

166.9

Recordkeeping (Business)

VS 13-2

(D)

(E)

KEEPER
(F)

(G)

(H)

(I)

(J)

(K)

6

1.0

6

0.08

1

0

50

12.0

600

1.00

600

0
1,410

0.10

141

Form 0579-0137
85.5

Permit to Move Restricted Animals

VS 1-27

0

Business

25

75.0

1,875

0.25

469

0

Accredited Veterinarian

5

1.0

5

0.50

3

0

State
85.6, 85.7

Owner-Shipper Statement (Business)

85.1, 85.6, 85.7,
85.8

Certificate of Veterinary Inspection

20

1.0

20

0.50

10

0

300

20.0

6,000

0.10

600

0
0

Business

4,500

30.0

135,000

0.25

33,750

0

Accredited Veterinarian

12,000

12.0

144,000

0.25

36,000

0

State

50

150.0

7,500

0.25

1,875

0

SUBTOTAL

295,006

73,308

1,410

141

INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting
and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1:
cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b;
cols. H & K = 13c.

TITLE OF INFORMATION COLLECTION DOCUMENT

OMB NO.

Swine Health Protection

0579-0065

(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.

DATE PREPARED

February 13, 2017
ANNUAL BURDEN

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT

REPORTS

RECORDS
TOTAL

FORMS NO
(S)
SECTION OF

DESCRIPTION

(If "none"

REGS.

NO. OF

NO OF

RESPONDENTS RESPONSES

so state)

PER

TOTAL ANNUAL

HOURS

TOTAL

NO. OF

ANNUAL

RECORD-

RESPONSES

PER

HOURS

RECORD-

HOURS PER

KEEPING HOURS

(Col. D x E)

RESPONSE

(Col. F x G)

KEEPERS

RECORD-

(Col. I x J)

RESPONDENT
(A)

(B)

(C)

85.10, 85.11

Accredited Veterinarian Statement: Embryo and
Semen Shipments (Business)

71.19

Swine Production System Health Plan

(D)

(E)

10

KEEPER
(F)

5.0

(G)

50.0

(H)

0.25

(I)

(J)

(K)

13

0
0

Business

100

1.0

100.0

1.00

100

0

State

25

5.0

125.0

0.25

31

0

71.19

Swine Production System Health Plan -Recordkeeping (Business)

71.19

Interstate Movement Report and Notification
(Business)

100

12.0

1200.0

0.25

300

0

71.19

Annual Report of PRV Control and Eradication
VS 7-1
Activities (State)

50

1.0

50.0

2.00

100

0

71.19

Annual Report of PRV Control and Eradication
Activities -- Recordkeeping (State)

52.3, 52.4

Appraisal and Indemnity Claim Form

52.2

125

50
VS 1-23

3.00

0.033

375

2
0

Business

15

1.0

15.0

0.25

4

0

State

5

2.0

10.0

0.50

5

0

Herd Management Plan

0.00
Business

15

1.0

15.0

0.25

4

0

State

5

2.0

10.0

0.50

5

0

SUBTOTAL

1575.0

561

175

377

INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting
and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1:
cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b;
cols. H & K = 13c.

TITLE OF INFORMATION COLLECTION DOCUMENT

OMB NO.

Swine Health Protection

0579-0065

(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.

DATE PREPARED

February 13, 2017
ANNUAL BURDEN

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT

REPORTS

RECORDS
TOTAL

FORMS NO
(S)
SECTION OF

DESCRIPTION

(If "none"

REGS.

NO. OF

NO OF

RESPONDENTS RESPONSES

so state)

PER

TOTAL ANNUAL

HOURS

TOTAL

NO. OF

ANNUAL

RECORD-

RESPONSES

PER

HOURS

RECORD-

HOURS PER

KEEPING HOURS

(Col. D x E)

RESPONSE

(Col. F x G)

KEEPERS

RECORD-

(Col. I x J)

RESPONDENT
(A)

52.5

(B)

(C)

Proceeds from Animals/Animal
VS 1-24
Products/Materials Sold for Slaughter (Business)

(D)

(E)

KEEPER
(F)

(G)

(H)

(I)

(J)

(K)

5

1.0

5.0

0.25

1

0.00

2

1.0

2.0

0.50

1

0.00

2

1.0

2

0.25

1

0

NEW
Appraisal Request for Affected Premises Using
Contract Growers
166.13

Notification by Licensee of Changes to Name,
Address, or Management (Business)

71.19

Recordkeeping for Buyers and Sellers of Swine
Moved Interstate (Business)

71.19

Identification of Swine Moving Interstate

VS 1-26

30,000

0.250

7500
0

Business
Accredited Veterinarian
State
71.19

Identification of Swine Moving Interstate -Recordkeeping (Business)

71.19

Cancellation of Withdrawal of a Swine
Production System Health Plan

15,000
100
50

52.0
5.0
260.0

780000.0
500.0
13000.0

2.00
2.00
2.00

1560000
1000
26000

0
0
0
15,000

0.500

7500
0.00

Business

2

1.00

2.0

1.00

2

0.00

State

2

1.00

2.0

1.00

2

0.00

SUBTOTAL

793513.0

1587007

45000

15000

INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting
and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1:
cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b;
cols. H & K = 13c.
(F)Total/(D)Total = (E)Average

TITLE OF INFORMATION COLLECTION DOCUMENT

OMB NO.

Swine Health Protection

0579-0065

(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.

DATE PREPARED

February 13, 2017
ANNUAL BURDEN

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT

REPORTS

RECORDS
TOTAL

FORMS NO
(S)
SECTION OF

DESCRIPTION

(If "none"

REGS.

NO. OF

NO OF

RESPONDENTS RESPONSES

so state)

PER

TOTAL ANNUAL

HOURS

TOTAL

NO. OF

ANNUAL

RECORD-

RESPONSES

PER

HOURS

RECORD-

HOURS PER

KEEPING HOURS

(Col. D x E)

RESPONSE

(Col. F x G)

KEEPERS

RECORD-

(Col. I x J)

RESPONDENT
(A)

(B)

(C)

71.19

Appeal of Cancellation of a Swine Production
System Health Plan (Business)

71.21(a)

Application for Permit To Move Slaughter Swine
from Originating Slaughter Facilities to
VS 1-38
Approved Destination Facilities

52.2

(D)

(E)

1

KEEPER
(F)

1.0

(G)

1.0

(H)

10.00

0.0

(I)

(J)

(K)

10

0

0

0.00

Business

20

2.00

40.0

2.00

80

0.00

State

5

8.00

40.0

6.00

240

0.00

Accredited Veterinarian

10

1.0

10.0

2.00

20

State

30

5.0

150.0

2.00

300

Shipment to Slaughter Seal

0.00
0
0
0
0
0.00

SUBTOTAL

241.0

650

0

0.00