Report of Identification of a Select Agent or Toxin from a Proficiency Test

Possession, Use, and Transfer of Select Agents and Toxins (42 CFR 73)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0576 can be found here:

Documents and Forms

Document Name Document Type
Report of Identification of a Select Agent or Toxin from a Proficiency Test Form and Instruction
REPORTING THE IDENTIFICATION OF A SELECT AGENT OR TOXIN Att7b-Form4B.PDF Form and Instruction
APHIS/CDC FORM 4B REPORTING THE IDENTIFICATION OF A SELECT AGENT OR TOXIN: Att4B-Rept the ID of Select Agent from Proficiency Test....pdf www.selectagents.gov/form4.html Form and Instruction

Information Collection (IC) Details

IC Title:	Report of Identification of a Select Agent or Toxin from a Proficiency Test	Agency IC Tracking Number:	0920-0576 18FL

Is this a Common Form? No		IC Status: Removed

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	NA	REPORTING THE IDENTIFICATION OF A SELECT AGENT OR TOXIN FROM A PROFICIENCY TEST (APHIS/CDC FORM 4B)	Att7b-Form4B.PDF	NA	Yes	Yes	Fillable Fileable
Form and Instruction	APHIS/CDC FORM 4B	REPORTING THE IDENTIFICATION OF A SELECT AGENT OR TOXIN: PROFICIENCY TESTING REPORT	Att4B-Rept the ID of Select Agent from Proficiency Test....pdf	http://www.selectagents.gov/form4.html	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title: 09-20-0170 National Select Agent Registry/Select Agent Transfer and Entity Registration Information System	FR Citation: 76 FR 4483

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-10	10
Annual IC Time Burden (Hours)	-5	5
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.