OMB control number

Gypsy Moth Identification Worksheet

OMB 0579-0104 · USDA/APHIS.

OMB 0579-0104

The identification worksheet is needed to evaluate and control Gypsy Moth infestations from entering the United States.

The latest form for Gypsy Moth Identification Worksheet expires 2026-08-31 and is listed under ICR 202102-0579-005.

Latest forms, documents, and information collections
Document	Type
Form PPQ-391 Insect Collection Worksheet for Genotype Analysis	Form
Form PPQ-391 Insect Collection Worksheet - State	Form
Form PPQ Form 377A Gypsy Moth Checklist and Record of Self-Inspection	Form and Instruction
Form PPQ Form 377 Gypsy Moth Checklist and Record of Your Self-Inspection	Form and Instruction
Form PPQ Form 377 Gypsy Moth Checklist and Record of Your Self-Inspection	Form and Instruction
Form PPQ Form 377 Gypsy Moth Checklist/Self Inspection - Individuals	Form and Instruction
0104 2021 APHIS 79 (20210913) amended.xlsx	Supplementary Document
0104 2021 APHIS 71 (20210913) amended.xlsx	Supplementary Document
0104 2022 comment 1.pdf	Public Comments
0104 2021 SS (202100921) amended - final.docx	Supporting Statement A
0104 2021 SS (20210921).docx	Supporting Statement A
0104 2021 APHIS 79 (20210913).xlsx	Supplementary Document
0104 2021 APHIS 79 (20210913).xlsx	Supplementary Document
0104 2021 APHIS 71 (20210913).xlsx	Supplementary Document
0104 2021 APHIS 71 (20210913).xlsx	Supplementary Document
Moving Industry Notification of Homeowners - Business	Information collection
Insect Collection Worksheet - State	Form
Insect Collection Worksheet - State	Form
Gypsy Moth Checklist/Self Inspection - Individuals	Form and Instruction
Gypsy Moth Checklist/Self Inspection - Individuals	Form and Instruction
Gypsy Moth Checklist/Self Inspection - Individuals	Form and Instruction
Gypsy Moth Checklist/Self Inspection - Individuals	Form and Instruction

Historical document collections
Reference	Filing	Received	Action
202102-0579-005	Extension without change of a currently approved collection	2021-09-22	Approved with change
201712-0579-007	Revision of a currently approved collection	2017-12-27	Approved with change
201403-0579-002	Revision of a currently approved collection	2014-08-19	Approved without change
201010-0579-021	Extension without change of a currently approved collection	2011-07-06	Approved without change
200802-0579-004	Extension without change of a currently approved collection	2008-07-16	Approved without change
200505-0579-003	Revision of a currently approved collection	2005-05-12	Approved without change
200203-0579-005	Revision of a currently approved collection	2002-03-29	Approved without change
199809-0579-005	Revision of a currently approved collection	1998-09-21	Approved without change
199508-0579-002	Revision of a currently approved collection	1995-08-07	Approved without change
199209-0579-001	Revision of a currently approved collection	1992-09-14	Approved without change
199206-0579-001	New collection (Request for a new OMB Control Number)	1992-06-22	Approved without change

Federal Enterprise Architecture: Natural Resources - Agricultural Innovation and Services

Information collection instruments
Form	Name	Electronic access	Type
Form PPQ-391	Insect Collection Worksheet for Genotype Analysis	www.aphis.usda.gov/library/forms/pdf/PPQ_Form_391.pdf	Form

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.