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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0920-0900
ICR Reference No:
201106-0920-017
Status:
Historical Active
Previous ICR Reference No:
201106-0920-007
Agency/Subagency:
HHS/CDC
Agency Tracking No:
Title:
Contact investigation Outcome Reporting Forms
Type of Information Collection:
New collection (Request for a new OMB Control Number)
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
09/05/2011
Retrieve Notice of Action (NOA)
Date Received in OIRA:
06/27/2011
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
09/30/2014
36 Months From Approved
Responses
3,347
0
0
Time Burden (Hours)
280
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
CDC's Division of Global Migration and Quarantine has developed contact investigation outcome reporting forms for the different types of investigations. This new data collection called "Contact Investigation Outcome Reporting Form supports the need for CDC Quarantine staff to evaluate its contact investigation investigative protocols and in determining if adequate information on each contact was provided to those responsible for contacting passengers believed to have been exposed to a communicable disease during travel.
Authorizing Statute(s):
None
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
75 FR 8057
12/22/2010
30-day Notice:
Federal Register Citation:
Citation Date:
76 FR 29243
05/20/2011
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
6
IC Title
Form No.
Form Name
Optional General Air/Land Contact Investigation Outcome Reporting Form
Optional General Maritime Contact Investigation Outcome Reporting Form
Optional Measles, Mumps or Rubella Air/Land Contact Investigation Outcome Reporting Form
Optional Measles, Mumps, or Rubella Maritime Contact Investigation Outcome Reporting Form
Optional TB Air/Land Contact Investigaiton Outcome Reporting Form
Optional TB Maritime Contact Investigation Outcome Reporting Form
ICR Summary of Burden
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
3,347
0
0
3,347
0
0
Annual Time Burden (Hours)
280
0
0
280
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
This is a NEW information collection request.
Annual Cost to Federal Government:
$8,211
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
Yes
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Thelma Sims 4046394771
Common Form ICR:
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:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(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;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
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.
Certification Date:
06/27/2011
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