View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0920-0006	ICR Reference No: 202401-0920-001
Status: Historical Active	Previous ICR Reference No: 202006-0920-005
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0006
Title: [NCEZID] Statement in Support of Application for Waiver of Inadmissibility Under Immigration and Nationality Act
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: 03/08/2024
	Date Received in OIRA: 01/19/2024
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2027	36 Months From Approved
Responses	200	0	0
Time Burden (Hours)	33	0	0
Cost Burden (Dollars)	3,260	0	0

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	200	200
Annual Time Burden (Hours)	33	33
Annual Cost Burden (Dollars)	3,260	3,260

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: The purpose of this submission is to request a Reinstatement with Change of a previously approved OMB approval of the information data collection. The information collection is related to waivers of inadmissibility on health-related grounds, specifically mental health disorders with associated harmful behavior. Information collected for waivers of other inadmissible health conditions is captured via I-601 or I-602 waiver forms administered by the Department of Homeland Security, therefore CDC is not requesting an information collection for those forms. CDC is updating the name, signature, title and address of US public health service reviewing official field on the information collection form 4.422-1. CDC’s Division of Global Migration and Health (DGMH) works closely with the Department of Homeland Security (DHS)’s office of U.S. Citizenship and Immigration Services (USCIS) and Department of State (DOS)’s consular offices.

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: Thelma Sims 4046394771

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