Report of Identification of a Select Agent or Toxin (APHIS/CDC Form 4) - Guidance

Possession, Use, and Transfer of Select Agents and Toxins (42 CFR 73)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0576 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-0576 Report of Identification of a Select Agent or Toxin (APHIS/CDC Form 4) - Guidance Form and Instruction
0920-0576 Guidance Document for the Completion of APHIS/CDC Form 4 Attachment 7c - APHIS-CDC_Form_4_Guidance_Document_2018-03-01.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Report of Identification of a Select Agent or Toxin (APHIS/CDC Form 4) - Guidance	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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 and Instruction	0920-0576	Guidance Document for the Completion of APHIS/CDC Form 4	Attachment 7c - APHIS-CDC_Form_4_Guidance_Document_2018-03-01.pdf	NA	Yes	No	Printable Only

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 4883

Number of Respondents: 1,030	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: 0 %

	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-1,030	1,030
Annual IC Time Burden (Hours)	-515	515
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.