Information Collection

Private Sector

IC 250534 under ICR 202111-0579-014 · OMB 0579-0485.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0579-0485 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form VS 10-4 Private Sector	Form and Instruction
VS 10-4 Specimen Submission VS 10-4 FEB 2021 (20210921) SEC.pdf	Form and Instruction
VS 10-4A Specimen Submission Continuation Sheet VS 10-4A AUG 2009 (20210921) SEC.pdf	Form
VS 17-29 Declaration of Importation VS 17-29 MAY 2017 (20210921) SEC.pdf	Form
VS 17-129 Application for Import or In-Transit Permit VS 17-129 DEC 2020 (20210921) SEC.pdf	Form

IC Title:

Private Sector

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 9 CFR 93

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	VS 10-4	Specimen Submission	VS 10-4 FEB 2021 (20210921) SEC.pdf	Yes	No	Fillable Printable
Form	VS 10-4A	Specimen Submission Continuation Sheet	VS 10-4A AUG 2009 (20210921) SEC.pdf	Yes	No	Fillable Printable
Form	VS 17-29	Declaration of Importation	VS 17-29 MAY 2017 (20210921) SEC.pdf	Yes	Yes	Fillable Printable
Form	VS 17-129	Application for Import or In-Transit Permit	VS 17-129 DEC 2020 (20210921) SEC.pdf	Yes	Yes	Fillable Fileable

Line of Business: Natural Resources

Subfunction: Agricultural Innovation and Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 265

Number of Respondents for Small Entity: 133

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 25 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50,118	50,118
Annual IC Time Burden (Hours)	26,734	26,734
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.