Information Collection Request

Restrictions on Interstate Travel of Persons

ICR 201512-0920-001 · OMB 0920-0488 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
42 CFR 70.3 Applicant to State of Destination for a Permit Form Removed Repair queued
Passenger Locator Form (Domestic) Form New Repair queued
42 CFR 70.4 Copy of Material submitted to Health Authority Form Removed Available
42 CFR 70.4 Report of Communcable Disease While in Interstate Travel by Master of Vessel Form Modified Repair queued
42 CFR 70.3 Permit Issued by State Health Authority Form Removed Repair queued
42 CFR 70.5 Application to Move from State to State - Communicable Period - Attending Physician Form Removed Repair queued
42 CFR 70.5 Application to Move from State to State - Communicable Period - Traveler Form Removed Repair queued
42 CFR 70.4 Copy of Materials for State or Local Health Authority Form Removed Repair queued
42 CFR 70.4 Report by Master Vessel or Person in Charge of Conveyance Form Removed Repair queued
42 CFR 70.3 Copy of Materials - Attending Physician Form Removed Available
Attachment 4 Privacy Impact Assessment.pdf Supplementary Document Uploaded 2016-04-29 Repair queued
Attachment 5 0920-0488 CDC Non-research determination.pdf Supplementary Document Uploaded 2016-04-29 Repair queued
Attachment 3 CDC FAA Memorandum of Agreement.pdf Supplementary Document Uploaded 2016-04-29 Repair queued
Interstate Travel_0920-0488_Supporting_Statement B_04292016 clean.doc Supporting Statement B Uploaded 2016-04-29 Available
Interstate Travel_0920-0488_Supporting_Statement A_04292016 clean.doc Supporting Statement A Uploaded 2016-04-29 Available
Attachment 5 0920-0488 CDC Non-research determination.pdf Supplementary Document Uploaded 2015-12-03 Repair queued
Attachment 4 Privacy Impact Assessment.pdf Supplementary Document Uploaded 2015-12-03 Repair queued
Attachment 1C 42 CFR 70.pdf Supplementary Document Uploaded 2015-12-03 Available
Attachment 1B 42 CFR 71.pdf Supplementary Document Uploaded 2015-12-03 Available
Attachment 1A Section 361 of the Public Health Service Act (42 USC 264).pdf Supplementary Document Uploaded 2015-12-03 Available
Attachment 2 60 day published.pdf Supplementary Document Uploaded 2015-12-03 Repair queued
ICR Details
0920-0488 201512-0920-001
Historical Active 201302-0920-007
HHS/CDC 18756
Restrictions on Interstate Travel of Persons
Revision of a currently approved collection   No
Regular
Approved with change 05/09/2016
Retrieve Notice of Action (NOA) 12/10/2015
  Inventory as of this Action Requested Previously Approved
05/31/2019 36 Months From Approved 05/31/2016
1,000 0 16,900
90 0 3,701
0 0 0

The goal of this information collection is to ensure that CDC can collect data related to communicable diseases or deaths that occur aboard conveyances during interstate travel within the United States. This revision request adds one new form and removes other forms that will not be used.

US Code: 42 USC 241 Name of Law: Public Health Service Act
   US Code: 42 USC 70-71 Name of Law: Interstate Quarantine
  
None

Not associated with rulemaking

  80 FR 53799 09/08/2015
80 FR 76692 12/10/2015
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 1,000 16,900 0 -15,900 0 0
Annual Time Burden (Hours) 90 3,701 0 -3,611 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
This revision requests the addition of one form and removes others that will not be used. There is an overall reduction in burden and respondents.

$334,837
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Jeffrey Zirger 404 639-7118 [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.
12/10/2015