View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0920-0891	ICR Reference No: 202201-0920-002
Status: Historical Active	Previous ICR Reference No: 201703-0920-004
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0891
Title: World Trade Center Health Program Enrollment, Appeals & Reimbursement
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/02/2022
	Date Received in OIRA: 01/06/2022
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2025	36 Months From Approved
Responses	28,977	0	0
Time Burden (Hours)	12,882	0	0
Cost Burden (Dollars)	146,417	0	0

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses	28,977	-38,017	66,994
Annual Time Burden (Hours)	12,882	-1,181	14,063
Annual Cost Burden (Dollars)	146,417	-946,295	1,092,712

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: Reinstatement is submitted to remove/add forms to 0920-0891 ICR package resulting in net decrease of 1,181 Burden Hours.

Annual Cost to Federal Government: $323,763

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. 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? No

Agency Contact: Jeffrey Zirger 404 639-7118 wtj5@cdc.gov

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