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Att 4C_Federal Law Enforcement Reporting Seizure of Select Agent of Toxin (APHIS/CDC) Form 4C
Possession, Use, and Transfer of Select Agents and Toxins (42 CFR 73)
OMB: 0920-0576
IC ID: 227782
OMB.report
HHS/CDC
OMB 0920-0576
ICR 202006-0920-017
IC 227782
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0576 can be found here:
2024-01-17 - Extension without change of a currently approved collection
2023-02-21 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Att 4C_Federal Law Enforcement Reporting Seizure of Select Agent of Toxin (APHIS/CDC) Form 4C
Form and Instruction
Reporting the Identification of a Select Agent or Toxin:
Att7c-Form4C.PDF
Form and Instruction
APHIS/CDC FORM 4C Reporting the Identification of a Select Agent or Toxin:
Att4C-Rept the ID of Select Agent fromFederal Law Enfor....pdf
www.selectagents.gov/form4.html
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Att 4C_Federal Law Enforcement Reporting Seizure of Select Agent of Toxin (APHIS/CDC) Form 4C
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: Federal Law Enforcement Seizure Report (APHIS/CDC Form 4C)
Att7c-Form4C.PDF
NA
Yes
Yes
Fillable Fileable
Form and Instruction
APHIS/CDC FORM 4C
Reporting the Identification of a Select Agent or Toxin: Federal Law Enforcement Seizure Report
Att4C-Rept the ID of Select Agent fromFederal Law Enfor....pdf
http://www.selectagents.gov/form4.html
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
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 4883
Number of Respondents:
1
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
0
0
0
-1
0
1
Annual IC Time Burden (Hours)
0
0
0
-1
0
1
Annual IC Cost Burden (Dollars)
0
0
0
0
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.