Form VS 4-10 VS 4-10 NVSL Contact Information Update

Clear Form
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0579-0430. The time required
to complete this information collection is estimated to average .1 hours per response, including the time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
VETERINARY SERVICES
NVSL ID Number:

NVSL Contact Information Update

Name of Individual (Optional):

Name of Business/Laboratory (Required):

Mailing Address:

City:

State:

ZIP Code:

Country:

Phone Number:

Fax Number:

Email Address(s):

Preferred Method of Contact (Select One) (Fax or Email Preferred):

□ Fax
□ Email
Comments/Additional Instructions:

□

United States Postal Service Mail

□ This record is no longer needed; remove it from your active files.
Return updated forms via one of the following ways:
Email:[email protected]
Fax Number: 515-337-7022
Mail: USDA/APHIS/VS/National Veterinary Services Laboratories
Attn: LIMS Contact Update
1920 Dayton Ave.
Ames, IA 50010
VS FORM 4-10
MAY 2015

OMB Approved
0579-0430
Exp. 04/2021