OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Emergency Submission to Supplement OMB Control Number 0920-0900 in Context of Contact Investigations Associated with Ebola and Travel

ICR 201410-0920-022 · OMB 0920-1032 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Airport or Other Port of Entry Staff Assessment Form New Repair queued
Cleaning Crew Assessment Form New Available
Flight Crew Assessment Form New Repair queued
Passenger Exposure Assessment Form New Available
Script Introduction and Confirmation Form New Available
Emergency Request Contact Investigations Part A.doc Supporting Statement A Uploaded 2014-10-16 Repair queued
USCODE-2009-title42-chap6A-subchapII-partG.pdf Supplementary Document Uploaded 2014-10-16 Available
Emergency Request Contact Investigations Part B.docx Supporting Statement B Uploaded 2014-10-16 Available
IC Document Collections
IC IDCollectionTypeStatusForm
213516 Airport or Other Port of Entry Staff Assessment Form New
213515 Cleaning Crew Assessment Form New
213514 Flight Crew Assessment Form New
213513 Passenger Exposure Assessment Form New
213512 Script Introduction and Confirmation Form New
ICR Details
0920-1032 201410-0920-022
Historical Active
HHS/CDC 15BW
Emergency Submission to Supplement OMB Control Number 0920-0900 in Context of Contact Investigations Associated with Ebola and Travel
New collection (Request for a new OMB Control Number)   No
Emergency 10/16/2014
Approved without change 10/16/2014
Retrieve Notice of Action (NOA) 10/16/2014
CDC will submit a revision to 0920-0900 if it is anticipated that this collection will continue for longer than six months. That decision must be made within two months in order to leave sufficient time to prepare the package in an orderly fashion.
  Inventory as of this Action Requested Previously Approved
04/30/2015 6 Months From Approved
33,000 0 0
4,749 0 0
0 0 0
The Centers for Disease Control and Prevention is requesting emergency clearance to perform contact investigations of individuals who may have come into contact with travelers that are confirmed to have Ebola infection.
Additional information is needed to better assess the risk to individuals who may have been exposed to a confirmed case of Ebola in the U.S.
US Code: 42 USC 70-71 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
No
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 33,000 0 0 33,000 0 0
Annual Time Burden (Hours) 4,749 0 0 4,749 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is an emergency Ebola related ICR request.
No
No
No
No
No
Uncollected
Carol Marsh 404 639-4773 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/16/2014