APHIS / CDC Forms
Overview
The APHIS/CDC Form 1, Application for Registration, is used by entities to register with APHIS or CDC. The Application for Registration requests facility information, a list of select agents or toxins in use, possession, or for transfer by the entity, characterization of the select agent or toxin, and laboratory information. Entities may also amend their registration if any changes occur in the information submitted to APHIS or CDC. To apply for an amendment to a certificate of registration, an entity must obtain the relevant portion of the APHIS/CDC Form 1 and submit the information requested in the package to APHIS or CDC.
APHIS/CDC Form 1 - Application for Registration for Possession, Use, and Transfer of Select Agents and Toxins provides additional information on application and amendment processes.
The APHIS/CDC Form 2, Request to Transfer Select Agent or Toxin, is used by entities to request authorization from APHIS or CDC to receive or send a select agent or toxin.
APHIS/CDC Form 2 - Request to Transfer Select Agents and Toxins provides additional information on the transfer request process.
The APHIS/CDC Form 3, Report of Theft, Loss, or Release of Select Agent or Toxin, is used by entities to report a theft, loss, or release of a select agent or toxin.
APHIS/CDC Form 3 - Report of Theft, Loss, or Release of Select Agents and Toxins provides additional information on this reporting process.
The APHIS/CDC Form 4, Report of Identification of Select Agent or Toxin, is used by clinical or diagnostic laboratories and other entities to notify APHIS or CDC of the identification of a select agent or toxin as the result of diagnosis, verification, or proficiency testing and the final disposition of that identified agent or toxin.
APHIS/CDC Form 4 – Report of the Identification of a Select Agent or Toxin provides additional information on this reporting process.
The APHIS/CDC Form 5, Request for Exemption, is used by an entity to request an exemption from the Select Agent Regulations for an investigational product or in cases of agriculture or public health emergency.
APHIS/CDC Form 5 - Request for Exemption of Select Agents and Toxins for Public Health or Agricultural Emergency or Investigational Product provides additional information on this request process.
All forms for the Select Agent Program have been reviewed and approved by the Office of Management and Budget as prescribed by the Paperwork Reduction Act of 1995. The only authorized location to obtain these forms is this website (www.selectagents.gov).