APHIS FORM 2049 Policy, Evaluation, and Licensing E-Submission Form

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 0.50 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 Approval 0579-0013 EXP DATE: xxxx
U.S. DEPARTMENT OF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE VETERINARY SERVICES, CENTER FOR VETERINARY BIOLOGICS (CVB) 1920 DAYTON AVE, AMES, IA 50010 VETERINARY BIOLOGICS REGULATORY E-SUBMISSION FORM POLICY, EVALUATION, AND LICENSING				See http://www.aphis.usda.gov/animal_health/vet_biologics/publications/electronicsubmissionguidancetosubmitters.pdf and http://www.aphis.usda.gov/animal_health/vet_biologics/ publications/submittalpicklistguidance.pdf for additional instructions.
Submission-Specific Folder ID on submitted electronic media (If more than one submission on a single disk )	Click here to enter text.
Related Prior Open Submissions (List only if current submission is a correction or addendum)	Click here to enter text.
USDA Veterinary Biologics Establishment Number (If no Establishment number has been assigned, enter name of submitting company.)	Click here to enter text.
All applicable Product Code(s) (If product not yet coded, enter UNASGN. If not product-related, enter NOTAPP)	Click here to enter text.
Special Outline No. (if applicable)	Click here to enter text.
Date Submitted	Click here to enter a date.
Submission Type
Submission Subtype (Multi-select if more than one applies)
Tags (Enter only if applicable. Multi-select if more than one applies.)	Paperless
Brief Description (Include study numbers, but be succinct; max 200 characters, and most should not need that many. Do not repeat information found in other rows of this template.)	Click here to enter text.
Direct submission to
Also notify (Equivalent to “cc” recipient)	Click here to enter text.
Related Prior Completed (Reviewed) Submissions	Click here to enter text.
Count of electronic files, by folder, provided with this submission	Core Documents	Statistical Data	Sequence Data
	Enter count	Enter count	Enter count
Submitter Signature

APHIS Form 2049

JUL 2014