Aphis 71

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

OMB NO.

0579-0214
DATE PREPARED

July 1, 2019

ANNUAL BURDEN

IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT

REPORTS

RECORDS
TOTAL

SECTION OF
REGS.

FORMS NO (S)
(If "none"
so state)

DESCRIPTION

NO. OF
RESPONDENTS

NO OF
RESPONSES
PER

TOTAL ANNUAL
RESPONSES
(Col. D x E)

HOURS
PER
RESPONSE

TOTAL
HOURS
(Col. F x G)

NO. OF
RECORDKEEPERS

ANNUAL
HOURS PER
RECORD-

RESPONDENT
(A)

(C)

(B)

(D)

(E)

RECORDKEEPING HOURS

(Col. I x J)

KEEPER
(F)

(G)

(H)

(I)

(J)

(K)

94.12
(c)(10)

Export Certificate (Foreign Government)

1

1.00

1.0

0.25

1

94.12(c)(9)

Collection of Information regarding Pork Used in
Pasta and Recordkeeping (Business)

1

1.00

1.0

1.00

1

94.12(c)(2)

Cooperative Service Agreement (Business)

1

1.00

1.0

0.16

1

0

1

1.00

1.0

1.00

1

0

0.0

0

0

0.0

0

0

4.0

4

1.00

1

TOTAL OF ALL PAGES

4.0

4

1.00

1

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

5.0

5

94.12 9c) (3) Storage Requirements (Business)

SUBTOTAL

2

0

1

1.00

1