Laboratory Assessment Requests

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0583-0183 can be found here:

Documents and Forms

Document Name Document Type
Form 8000-17 Laboratory Assessment Requests Form
8000-17 Evidence Receipt and Chain of Custody FSIS 8000-17 EVIDENCE RECEIPT AND CHAIN OF CUSTODY.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Laboratory Assessment Requests	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	8000-17	Evidence Receipt and Chain of Custody	FSIS 8000-17 EVIDENCE RECEIPT AND CHAIN OF CUSTODY.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	12	12
Annual IC Time Burden (Hours)	23	23
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.