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Dog Permit Application Form
Importation Regulations (42 CFR 71 Subpart F)
OMB: 0920-1383
IC ID: 253387
OMB.report
HHS/CDC
OMB 0920-1383
ICR 202205-0920-004
IC 253387
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1383 can be found here:
2024-06-05 - Revision of a currently approved collection
2023-01-18 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 0920-22BY
Dog Permit Application Form
Form and Instruction
0920-22BY Dog Permit Application Form
Attachment C_Dog Permit Application Form.docx
Form and Instruction
0920-22BY Dog Permit Application Form
Attachment C_Dog Permit Application Form.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Dog Permit Application Form
Agency IC Tracking Number:
0920-22BY
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Mandatory
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
0920-22BY
Dog Permit Application Form
Attachment C_Dog Permit Application Form.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
Quarantine- and Traveler-Related Activities
FR Citation:
83 FR 6591
Number of Respondents:
60,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
60,000
0
60,000
0
0
0
Annual IC Time Burden (Hours)
60,000
0
60,000
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.