APHIS/CDC Form 4A Quick Reference Guide:
Completing Sections A & B

  1. 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.
  2. Complete Section A.
    1. Answer Questions 1-3image icon. Questions 4-11 will be auto populated.
  3. Complete Section Bimage icon.
    1. For questions 1 and 2, select the agent or toxin identified and provide date identified.
    2. For questions 3 and 4, if immediate notification is required for the select agent or toxin identified follow the Immediate Notification Quick Reference Guide.
    3. For question 5, enter the number of samples received.
    4. For question 6, select the sample type received.
    5. For question 7, if the sample origin is international, leave this field blank or enter “00000”.
    6. Provide the international location in the question 16 comments box.
    7. For question 8, select all that apply.
    8. For question 9, select all that apply:
      1. Transferred – Indicate to whom the sample was sent and the date of the transfer.
      2. Destroyed – Indicate method of destruction and date destroyed.
      3. Retained – Indicate PI (from the dropdown menu of PIs approved to possess select agent and toxin.
    9. If yes to question 10image icon, complete an APHIS/CDC Form 3.
    10. If yes to question 11image icon, provide the date the sender was notified of the identification and complete questions 14-21image icon.
  4. For question 13: If the sample provider is an international source select ‘Yes’ and provide the name of the country.
  5. 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.
  6. 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