APHIS/CDC Form 4A Quick Reference Guide: Completing Sections A & B
- Log into eFSAP. Click on Form 4. Click Create Form 4A – Section A&B. If completing the remainder of a Form 4 from an immediate notification, access the previously submitted Form 4 by clicking on the View buttonimage icon adjacent to the appropriate ID under Form 4 Section A&B.
- Fill out Section A.
- Answer Questions 1–3. Questions 4-13 should be filled out automatically.
- Fill out Section Bimage icon.
- For Question 1, select the closest agent or toxin identified.
- For Question 6, 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 8image icon, you may select more than one option:
- 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 you answer yes to Question 9, you will need to fill out an APHIS/CDC Form 3 as well.
- If you answer yes to Question 11, you will also need to answer questions 12-15. Click Add Rowimage icon.
- Note: If the sample provider submitted the entire specimen to the reference laboratory and did not work on the specimen, the reference laboratory must note this in the comment field.
- For international sample providers, provide any additional details on the sample provider here, including the date the sample provider was notified of the identification.
- Click Submitimage icon. Clicking Save does NOT submit the Form 4 Section A&B.
Page last reviewed: August 27, 2020
Content source: Division of Select Agents and Toxins