APHIS/CDC Form 5 - Request for Exemption of Select Agents and Toxins for Public Health or Agricultural Emergency or Investigational / Experimental Product
Description
This form should be used to apply for exemption from the requirements of 7 CFR 331, 9 CFR 121, or 42 CFR 73 in cases of:
- (a) Use of an investigational product, or,
- (b) Due to public health or agricultural emergency.
This exemption request should be sent to either APHIS or CDC, as appropriate, for exemption consideration.
Directions
If you will be completing the form electronically, download the fillable PDF below, then complete print, and sign the form. If you will be completing the form by hand, use the print only PDF, then print, complete and sign the form. All completed forms must be submitted via fax or mail directly to CDC or APHIS.
Download
- Fillable PDF:
APHIS/CDC Form 5
(PDF 594K)
- Print Only PDF:
APHIS/CDC Form 5
(PDF 66K)
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