Information Collection

Private Sector

IC 2183 under ICR 201808-0579-004 · OMB 0579-0101.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form VS 5-18
Record of Animals Moved Private Sector
Form
Form VS 5-19D
Scrapie Epidemiology Report Private Sector
Form
Form VS 5-19
Flock Inspection and Epidemiology Report Private Sector
Form
Form VS 5-20
Individual Animal Information Report Private Sector
Form
Form VS 1-23
Appraisal and Indemnity Claim Form Private Sector
Form
Form VS 1-23A
Indemnity Worksheet - Owner/Company Private Sector
Form
Form VS 1-24
Proceeds from Animals/Animal Products/Materials Sold for Salvage Private Sector
Form
Form VS 5-19C
Scrapie PEMMP Inspection Report Private Sector
Form
Form VS 5-29
Cooperative State - Scrapie Control Program Private Sector
Form
Form VS 5-29 A
Scrapie Test Record - Continuation Sheet Private Sector
Form
Form VS 10-4
Specimen Submission Private Sector
Form
Form VS 5-22
Application for the Scrapie Flock Certification Program Private Sector
Form
Form VS 5-18 A
Record of Animals Acquired Private Sector
Form
Form VS 5-19 A
Flock Inspection and Epidemnity Report Initial Flock Inspection for Complete Monitored Status in SCrapie Flock Certification Program Private Sector
Form
Form VS 5-19 b
Flock Inspection and Epidemiology Report Flock Inspection for Complete Monitored Status in the Scrapie Flock Certification Program Private Sector
Form
Form VS 17-140
United States Origin Health Certificate Private Sector
Form
Form VS 1-27
Permit for Movement of Restricted Animals Private Sector
Form
VS 5-18 Record of Animals Moved
VS 5-18 Dec 2011.pdf

www.aphis.usda.gov/library/forms/pdf/vs5_18.pdf
Form
VS 5-19D Scrapie Epidemiology Report
VS 5-19D Feb_FINAL.doc
Form
VS 5-19 Flock Inspection and Epidemiology Report
VS 5-19 DEC 2011.pdf
Form
VS 5-20 Individual Animal Information Report
VS 5-20 DEC 2011.pdf
Form
VS 1-23 Appraisal and Indemnity Claim Form
VS 1-23 AUG 2018.pdf
Form
VS 1-23A Indemnity Worksheet - Owner/Company
VS 1-23A-work May 2009.doc
Form
VS 1-24 Proceeds from Animals/Animal Products/Materials Sold for
VS 1-24 AUG 2018.pdf
Form
VS 5-19C Scrapie PEMMP Inspection Report
VS 5-19C Feb_FINAL.pdf
Form
VS 5-29 Cooperative State - Scrapie Control Program
VS 5-29 DEC 2011.pdf
Form
VS 5-29 A Scrapie Test Record - Continuation Sheet
VS 5-29A DEC 2011.pdf
Form
VS 10-4 Specimen Submission
VS 10-4 Aug 2009.doc

www.aphis.usda.gov/library/forms/pdf/VS_Form10_4.pdf
Form
VS 5-22 Application for the Scrapie Flock Certification Program
REV VS 5-22 June 2013 Final.pdf

www.aphis.usda.gov/library/forms/pdf/vs5_22.pdf
Form
VS 5-18 A Record of Animals Acquired
VS 5-18A Dec 2011.pdf

www.aphis.usda.gov/library/forms/pdf/vs5_18.pdf
Form
VS 5-19 A Flock Inspection and Epidemnity Report Initial Flock Ins
REV VS 5-19A June 2013 Final.pdf
Form
VS 5-19 b Flock Inspection and Epidemiology Report Flock Inspectio
REV VS 5-19B June 2013 Final.pdf
Form
VS 17-140 United States Origin Health Certificate
REV VS 17-140 NOV 2014.pdf
Form
VS 1-27 Permit for Movement of Restricted Animals
VS 1-27 JUL 2011.doc
Form
How to Create an On-Line CVI for AV.ppt
How to Create an On-Line CVI for AV
IC Document
Appendix A-1 FY 2010 Scrapie CA Guidance.docx
Appendix A-1 FY 2010 Scrapie CA Guidance
IC Document
Appendix A-2 Coop Agreement Award ASI 10-9100-1231.pdf
Appendix A-2 Coop Agreement Award ASI 10-9100-1231
IC Document
Appendix A-3 NIAAGrant.pdf
Appendix A-3 NIAAGrant
IC Document
Appendix A-4_ MOU template for scrapie.doc
Appendix A-4_ MOU template for scrapie
IC Document
Appendix B_10-4 and 5-29 worksheets.docx
Appendix B_10-4 and 5-29 worksheets
IC Document
Appendices C-E screenshots.doc
Appendices C-E screenshots
IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 VS 5-18 http://www.aphis.usda.gov/library/forms/pdf/vs5_18.pdf Yes No Printable Only
Form VS 5-19D No   Paper Only
Form VS 5-19 No   Paper Only
Form VS 5-20 No   Paper Only
Form VS 1-23 No   Paper Only
Form VS 1-23A No   Paper Only
Form VS 1-24 No   Paper Only
Form VS 5-19C No   Paper Only
Form VS 5-29 No   Paper Only
Form VS 5-29 A No   Paper Only
Form VS 10-4 http://www.aphis.usda.gov/library/forms/pdf/VS_Form10_4.pdf Yes No Printable Only
Form VS 5-22 http://www.aphis.usda.gov/library/forms/pdf/vs5_22.pdf Yes No Printable Only
Form VS 5-18 A http://www.aphis.usda.gov/library/forms/pdf/vs5_18.pdf Yes No Printable Only
Form VS 5-19 A No   Paper Only
Form VS 5-19 b No   Paper Only
Form VS 17-140 No   Paper Only
Form VS 1-27 No   Paper Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 853,731 0 0 0 0 853,731
Annual IC Time Burden (Hours) 958,989 0 0 0 0 958,989
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
How to Create an On-Line CVI for AV 11/15/2012
Appendix A-1 FY 2010 Scrapie CA Guidance 11/15/2012
Appendix A-2 Coop Agreement Award ASI 10-9100-1231 11/15/2012
Appendix A-3 NIAAGrant 11/15/2012
Appendix A-4_ MOU template for scrapie 11/15/2012
Appendix B_10-4 and 5-29 worksheets 11/15/2012
Appendices C-E screenshots 11/15/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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