View Information Collection Request (ICR) Package
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View ICR - Agency Submission
COMMENT
Time Remaining
Days
HR
Min
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OMB Control No:
0920-0134
ICR Reference No:
202603-0920-008
Status:
Received in OIRA
Previous ICR Reference No:
202412-0920-009
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-26-0139
Title:
[NCEZID] Land Travel-related Public Health Activities
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
Date Submitted to OIRA:
03/19/2026
Requested
Previously Approved
Expiration Date
36 Months From Approved
03/31/2026
Responses
590
14,616
Time Burden (Hours)
156
2,078
Cost Burden (Dollars)
0
21,910
Abstract:
The goal of this information collection is to facilitate a CDC public health mission as provided under the Public Health Service Act and Code of Federal Regulations. This Revision consolidates land travel-related public health information collections under one OMB control number, thereby improving efficiency of CDC’s land travel-related activities PRA submission process. It modifies current forms and add/deletes other forms which results in a burden change.
Authorizing Statute(s):
Statute at Large:
42 Stat. 70
Statute at Large:
42 Stat. 71
US Code:
42 USC 264
Name of Law: Public Health Service Act
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:
91 FR 1320
01/13/2026
30-day Notice:
Federal Register Citation:
Citation Date:
91 FR 12805
03/17/2026
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
7
IC Title
Form No.
Form Name
42CFR71.33(c) Report by Persons in Isolation or Surveillance ((no form))
42CFR71.35_Report of Dealth Illness During Stay in Port ((verbal, no form))
Air Travel Illness or Death Investigation Form
0920-0134
Air Travel Illness or Death Investigation Form
Att H_42CFR71.21(a )_ Maritime Conveyance Illness or Death Investigation Form (Sections 1-4)
42CFR 71.21(a)
Maritime Conveyance illness or Death Investigation Form
Att I_42CFR71.21(b)_Death/Illness Reports from Aircraft
Cumulative Influenza/Influenza-Like Illness (ILI) Form
none
Cumulative Influenza/Influenza-Like Illness (ILI) Form
Domestic Land Conveyance Manifest Order Template
General Land Contact Investigation Outcome Reporting Form
n/a
General Land Conveyance Contact Investigation Outcome Reporting Form
International Land Conveyance Manifest Order Template
Land Passenger Locator Form
n/a
Public Health Land Passenger Locator Form
Land Travel Illness or Death Investigation Form
none
Land Travel Illness or Death Investigation Form
Maritime Conveyance Illness or Death Investigation Form (Section 5)
0920-25CC
Maritime Conveyance Illness or Death Investigation Form Section 5
Report by the Master of a Vessel or Person in Charge of Conveyance of the Incidence of a Communicable Disease Occurring While in Interstate Travel
TB Land Contact Investigation Outcome Reporting Form
n/a
Tuberculosis Land Conveyance Contact Investigation Outcome Reporting Form
ICR Summary of Burden
Total Request
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
590
14,616
0
-14,026
0
0
Annual Time Burden (Hours)
156
2,078
0
-1,922
0
0
Annual Cost Burden (Dollars)
0
21,910
0
-21,910
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:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
The burden change is due to adding and removing forms.
Annual Cost to Federal Government:
$214,197
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?
Yes
Agency Contact:
Kevin Joyce 404 639-1944 kdj7@cdc.gov
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:
03/19/2026
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