Private Sector

Control of Chronic Wasting Disease

Documents and Forms

Document Name Document Type
Form VS 1-23 Private Sector Form and Instruction
VS 1-23 Appraisal and Indemnity Claim for Animals Destroyed and VS 1-23 AUG 2018 SEC.pdf Form and Instruction
VS 10-4 Specimen Submission VS 10-4 FEB 2021 SEC.pdf www.aphis.usda.gov/library/forms/pdf/VS_Form10_4.pdf Form and Instruction
VS 11-2 Application for Chronic Wasting Disease Herd Certificati VS 11-2 APR 2012 SEC.pdf www.aphis.usda.gov/library/forms/pdf/VS11_2.pdf Form
VS 10-4 Specimen Submission VS 10-4 OCT 2023 (20250122).pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Private Sector	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 9 CFR 55.1 - 55.25 9 CFR 81.2 - 81.4

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	VS 1-23	Appraisal and Indemnity Claim for Animals Destroyed and Materials Destroyed	VS 1-23 AUG 2018 SEC.pdf		No		Paper Only
Form and Instruction	VS 10-4	Specimen Submission	VS 10-4 FEB 2021 SEC.pdf	http://www.aphis.usda.gov/library/forms/pdf/VS_Form10_4.pdf	Yes	No	Fillable Printable
Form	VS 11-2	Application for Chronic Wasting Disease Herd Certification Program (CWD HCP) Approval, Renewal, or Reinstatement of a State	VS 11-2 APR 2012 SEC.pdf	https://www.aphis.usda.gov/library/forms/pdf/VS11_2.pdf	Yes	No	Fillable Printable
Form and Instruction	VS 10-4	Specimen Submission	VS 10-4 OCT 2023 (20250122).pdf		Yes	No	Fillable Printable

Line of Business: Natural Resources

Subfunction: Agricultural Innovation and Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 9,024	Number of Respondents for Small Entity: 6,768

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 50 %

	Requested	Previously Approved
Annual Number of Responses for this IC	47,923	47,923
Annual IC Time Burden (Hours)	251,021	251,021
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.