View Information Collection Request (ICR) Package

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: 0920-0006	ICR Reference No: 202006-0920-005
Status: Historical Active	Previous ICR Reference No: 201703-0920-013
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0006
Title: Statement in Support of Application for Waiver of Inadmissibility Under Immigration and Nationality Act
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: 12/23/2020
	Date Received in OIRA: 06/23/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2023	36 Months From Approved	12/31/2020
Responses	200	0	400
Time Burden (Hours)	33	0	100
Cost Burden (Dollars)	3,260	0	16,000

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	200	400	-200
Annual Time Burden (Hours)	33	100	-67
Annual Cost Burden (Dollars)	3,260	16,000	-12,740

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Burden is reduced due to the elimination of one form as CDC does not receive information about the evaluation report of an applicant who received a waiver.

Annual Cost to Federal Government: $72,634

Does this IC contain surveys, censuses, or employ statistical methods? No

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? No

Agency Contact: Shari Steinberg 404 639-4942 sxw2@cdc.gov

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