APHIS/CDC Form 4B Quick Reference Guide

Download PDF pdf icon[PDF – 162 KB]

1. Log into eFSAP. Click on Form 4. Click Create Form 4B.
2. Fill out Section Aimage icon.
   1. For Question 1, select the closest agent or toxin identified.
   2. For Question 4, if you are a registered entity, you must provide your FSAP Registration #. If you are a clinical or diagnostic laboratory (non-registered entity), you must provide the NRE# provided to you by FSAP.
   3. The answer to question 14image icon is provided by the sponsor.
3. Fill out Section B.
   1. For question 4image icon, you may select more than one option:
      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. If you are a non-registered entity, you may not retain the select agent and cannot select this as an option.
   2. If you answer Yes to question 5, you will need to fill out a Form 3.
4. Type your name in the Signature of Respondent fieldimage icon. The date will auto-populate.
5. Click Submit. Clicking Save does NOT submit the Form 4B.