Aphis 2015 Transmittal Of Lables And Circulars Or Outlines

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0579-0013. The time required to complete this information collection is estimated to average 0.05 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

OMB Approved 0579-0013 EXP. DATE XX/XXXX

No U.S. Veterinary Biological Product License may be issued until product labels, circulators and outline of products have been reviewed. (9 CFR 102, 112, and 114).

U.S. OEPARTMENT OF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE VETERINARY SERVICES CENTER FOR VETERINARY BIOLOGICS AMES, IOWA 50010 TRANSMITTAL OF LABELS AND CIRCULARS OR OUTLINES

1. NAME AND ADDRESS OF LICENSEE (Include ZIP Code)

NOTE: Submit original and 6 copies. Retain last copy.

2. DATE OF PRIOR RELATED CORRESPONDENCE

3. ESTABLISHMENT LICENSE NUMBER.

. 4. DATE SUBMITTED

5. NAME OF PRODUCT (Use separate form for each product)

8. PROOUCT CODE

7. “X” IF NEW PRODUCT

LABELS AND CIRCULARS SUBMITTED

type

FINISHED

SKETCHES

A. Number Sets

B. Number Copies Of Each

C. Item on File Being Replaced (Give Number(s))

D. Number Sets

E. Number Copies Of Each

F. Item on File Being Replaced (Give Number(s))

8. CONTAINER

9. BOX

10. CIRCULARS

11. OTHER

OUTLINE SUBMITTED (Do not submit with same form covering Labels and Circulars)

12. NUMBER COPIES

13. TYPE OF SUBMISSION

14. PAGE NUMBERS AMENDED OR ADDED

15. DATE OF PREVIOUS OUTLINE

New Online

Complete Revision

Pages Amended

Pages Added

16. COMMENTS

17. SIGNATURE OF LICENSEE REPRESENTATIVE

18.TITLE

REVIEW BY VETERINARY BIOLOGICS

EXCEPTIONS

20. REVIEWED BY (Signature, Veterinary Biologics)

21. DATE RETURNED

APHIS FORM 2015 Previous editions are obsolete.

OCT 2011