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Federal forms, ICRs, and supporting documents

Information Collection Request

Airline and Traveler Information Collection: Domestic Manifests and the Passenger Locator Form (42 CFR Part 70 and 71)

ICR 202003-0920-003 · OMB 0920-1181 · Historical Inactive

Forms and Documents
DocumentTypeStatusAvailability
Passenger Locator Form - domestic flights Form Unchanged Available
Passenger Locator Form - limited onboard exposure int'l flights Form Unchanged Repair queued
Passenger Locator Form - outbreak of PH significance int'l flights Form Modified Repair queued
0920-1181 RWA PLF Change 03042020 omb DGMQ Clean.docx Justification for No Material/Nonsubstantive Change Uploaded 2020-03-04 Repair queued
Attachment 13 System of Record Notice.pdf Supplementary Document Uploaded 2017-05-03 Repair queued
Attachment 12 Approval for Removal of Expiration Date.pdf Supplementary Document Uploaded 2016-11-02 Repair queued
Attachment 10 Receipt of manifest letter.doc Supplementary Document Uploaded 2016-11-02 Available
Attachment 8 IATA Passenger Manifest Information Request Form.pdf Supplementary Document Uploaded 2016-11-02 Repair queued
Attachment 7 Order Cover Letter.doc Supplementary Document Uploaded 2016-11-02 Available
Attachment 4 CDC Nonresearch determination Letter.pdf Supplementary Document Uploaded 2016-10-31 Repair queued
Attachment 3 QARS Privacy Impact Assessment.pdf Supplementary Document Uploaded 2016-10-31 Available
Attach 2 PLF 60 day 9.2.16.pdf Supplementary Document Uploaded 2016-10-31 Repair queued
Attachment 1C 42 CFR part 70.pdf Supplementary Document Uploaded 2016-10-31 Available
Attachment 1B 42 CFR part 71.pdf Supplementary Document Uploaded 2016-10-31 Repair queued
Attachment 1A Section 361 of the Public Health Service Act (42 USC 264).docx Supplementary Document Uploaded 2016-10-31 Available
0920-XXXX_Domestic Manifest PLF Supporting Statement Part B.doc Supporting Statement B Uploaded 2016-10-31 Available
Domestic Manifest PLF Supporting Statement Part A 04242017.doc Supporting Statement A Uploaded 2017-05-03 Available
IC Document Collections
IC IDCollectionTypeStatusForm
224286 Passenger Locator Form - domestic flights Form Unchanged
224285 Passenger Locator Form - limited onboard exposure int'l flights Form Unchanged
224284 Passenger Locator Form - outbreak of PH significance int'l flights Form Modified
224253 Domestic non-TB Manifest Template and Informal Manifest Request Instruction Unchanged
224252 Domestic TB Manifest Template or Informal Manifest Request Instruction Unchanged
ICR Details
0920-1181 202003-0920-003
Historical Inactive 201610-0920-015
HHS/CDC
Airline and Traveler Information Collection: Domestic Manifests and the Passenger Locator Form (42 CFR Part 70 and 71)
No material or nonsubstantive change to a currently approved collection   No
Regular
Withdrawn and continue 05/13/2020
Retrieve Notice of Action (NOA) 03/04/2020
  Inventory as of this Action Requested Previously Approved
05/31/2020 05/31/2020 01/31/2021
2,701,629 0 2,701,629
225,308 0 225,308
0 0 0
This information collection ensures that, consistent with the authorities in the Public Health Service Act and in Code of Federal Regulations (CFR), CDC can collect conveyance, passenger and crew member manifest information (manifests) and Passenger Locator Forms (PLF) in the event an individual with a confirmed or suspected case of a communicable disease is known to have traveled on an interstate flight while infectious or potentially infectious and presented a risk of spread to other passengers or crew. This is collected so CDC can initiate the process of contact tracing or provision of other public health follow up to prevent further disease spread. The Non-Substantive Change Request, is submitted for the addition of a web-based version of the PLF.
Statute at Large: 42 Stat. 70 Name of Statute: Interstate Quarantine
   Statute at Large: 42 Stat. 71 Name of Statute: Foreign Quarantine
   US Code: 42 USC 264 Name of Law: Public Health and Welfare
  
None
Not associated with rulemaking
  81 FR 60702 09/02/2016
81 FR 78165 11/07/2016
No
No
No
$355,282
No
    Yes
    Yes
No
No
No
No
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.
03/04/2020