Dog Permit Application Form

[NCEZID] Importation Regulations (42 CFR 71 Subpart F)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1383 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-22BY Dog Permit Application Form Form and Instruction
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
0920-1383 CDC RABIES VACCINATION AND MICROCHIP RECORD Standard rabies vaccination certificate form_0920-1383.docx Form and Instruction
0920-1383 CDC RABIES VACCINATION AND MICROCHIP RECORD Standard rabies vaccination certificate form_0920-1383.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Dog Permit Application Form	Agency IC Tracking Number:	0920-22BY

Is this a Common Form? No		IC Status: Modified

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
Form and Instruction	0920-1383	CDC RABIES VACCINATION AND MICROCHIP RECORD	Standard rabies vaccination certificate form_0920-1383.docx	NA	Yes	Yes	Fillable Fileable

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	Previously Approved
Annual Number of Responses for this IC	60,000	60,000
Annual IC Time Burden (Hours)	60,000	60,000
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.