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: 201802-0920-005
Status: Historical Active	Previous ICR Reference No: 201712-0920-005
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0900-18GZ
Title: Contact Investigation Outcome Reporting Forms
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/21/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/20/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2021	36 Months From Approved	06/30/2018
Responses	1,036	0	6,495
Time Burden (Hours)	109	0	786
Cost Burden (Dollars)	4,055	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	1,036	6,495	-5,459
Annual Time Burden (Hours)	109	786	-677
Annual Cost Burden (Dollars)	4,055	0	4,055

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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This Revision incorporates new forms for 2 conditions: varicella and influenza-like illness. A number of forms were discontinued: non-TB maritime forms and all Ebola forms. The estimated number of TB contact investigation forms is lower, but the burden per response for each report is higher. Some forms include updated content. All changes are summarized in detail in Section A.15.

Annual Cost to Federal Government: $221,716

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. No

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: Renita Macaluso 770 488-6458 arp5@cdc.gov