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Centers for Disease Control and Prevention
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Select Agent Program
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Please note that all forms for the Select Agent Program have been reviewed and approved by the Office of Management and Budget as prescribed by the Paperwork Reduction Act of 1995. The only authorized location to obtain these forms is this website and that of the Animal Plant Health and Inspection Service (APHIS), U.S. Department of Agriculture.

CDC FORM 0.1316 / APHIS FORM 2043 - Report of Theft, Loss, or Release of Select Agents and Toxins pdf (PDF 145K)

  • Fillable PDF: Form pdf (PDF 601K)

CDC FORM 0.1317 / APHIS FORM 2042 - Request For Exemption of Select Agents and Toxins PDF version (PDF 135K)

  • Fillable PDF: Form pdf (PDF 225K)

CDC FORM 0.1318 / APHIS FORM 2040 - Report of the Identification of a Select Agent or Toxin in a Clinical or Diagnostic Laboratory PDF version (PDF 159K)

  • Fillable PDF: Form pdf (PDF 502K)

CDC FORM EA101 / APHIS FORM 2041 - Report of Transfer of Select Agents and Toxins PDF version (PDF 174K)

  • Fillable PDF: Form pdf (PDF 773K)


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This page last reviewed September 21, 2004

United States Department of Health and Human Services
Centers for Disease Control and Prevention
Office of the Director
Select Agent Program