Get USDA FSIS 5200-15 2012

SIGNATURE OF APPLICANT 6. PRINTED NAME 7. PRINT NAME OF DISTRICT/ IID - HEADQUARTER MANAGER FSIS FORM 5200-15 1/19/2012 8. 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 0583-0153. The time required to complete this information collection is estimated to average 20 minutes 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* U* S* DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE HOURS OF OPERATION REQUEST/APPROVAL 1. NAME OF APPLICANT 2. DATE OF REQUEST 3. DISTRICT / IID-HEADQUARTER OFFICE 4. MAILING ADDRESS OF APPLICANT New Attach to application form Update or Revision HOURS OF OFFICIAL INSPECTION OPERATIONS REQUESTED - SHIFT I DAY OF WEEK SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY Start Time Lunch Break Start Break End End Time 5. 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 0583-0153. The time required to complete this information collection is estimated to average 20 minutes 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* U* S* DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE HOURS OF OPERATION REQUEST/APPROVAL 1. The valid OMB control number for this information collection is 0583-0153. The time required to complete this information collection is estimated to average 20 minutes 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* U* S* DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE HOURS OF OPERATION REQUEST/APPROVAL 1. NAME OF APPLICANT 2. DATE OF REQUEST 3. DISTRICT / IID-HEADQUARTER OFFICE 4. MAILING ADDRESS OF APPLICANT New Attach to application form Update or Revision HOURS OF OFFICIAL INSPECTION OPERATIONS REQUESTED - SHIFT I DAY OF WEEK SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY Start Time Lunch Break Start Break End End Time 5. 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 0583-0153. The time required to complete this information collection is estimated to average 20 minutes 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* U* S* DEPARTMENT OF AGRICULTURE FOOD SAFETY AND INSPECTION SERVICE HOURS OF OPERATION REQUEST/APPROVAL 1. NAME OF APPLICANT 2. DATE OF REQUEST 3. DISTRICT / IID-HEADQUARTER OFFICE 4. MAILING ADDRESS OF APPLICANT New Attach to application form Update or Revision HOURS OF OFFICIAL INSPECTION OPERATIONS REQUESTED - SHIFT I DAY OF WEEK SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY Start Time Lunch Break Start Break End End Time 5. .