APHIS/CDC Form 4A Quick Reference Guide:
Completing Sections A & B
- Log into eFSAP. Click on Form 4. Click Create Form 4A – Section A&Bimage icon. If completing the remainder of a Form 4A from an immediate notification, access the previously submitted Form 4A by clicking on the View button adjacent to the appropriate CID under Form 4A Section ABs.
- Complete Section A.
- Answer Questions 1-3image icon. Questions 4-11 will be auto populated.
- Complete Section Bimage icon.
- For questions 1 and 2, select the agent or toxin identified and provide date identified.
- For questions 3 and 4, if immediate notification is required for the select agent or toxin identified follow the Immediate Notification Quick Reference Guide.
- For question 5, enter the number of samples received.
- For question 6, select the sample type received.
- For question 7, if the sample origin is international, leave this field blank or enter “00000”.
- Provide the international location in the question 16 comments box.
- For question 8, select all that apply.
- For question 9, select all that apply:
- Transferred – Indicate to whom the sample was sent and the date of the transfer.
- Destroyed – Indicate method of destruction and date destroyed.
- Retained – Indicate PI (from the dropdown menu of PIs approved to possess select agent and toxin.
- If yes to question 10image icon, complete an APHIS/CDC Form 3.
- If yes to question 11image icon, provide the date the sender was notified of the identification and complete questions 14-21image icon.
- For question 13: If the sample provider is an international source select ‘Yes’ and provide the name of the country.
- For questions 14-21: Enter the name and contact information of the sample provider and point of contact at that entity. Click Add Row after entering questions 14-21.
- Click Submitimage icon. Clicking Save does NOT submit the Form 4A Sections A&B but puts the form in ‘Draft’ status not ‘Submitted’ status.
Page last reviewed: August 27, 2020
Content source: Division of Regulatory Science and Compliance