Registration of Individuals Displaced by the Hurricanes Katrina and Rita

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Non-temporary housing unit occupant - main questionnaire	Form	New	Repair queued
Non-temporary housing unit occupant - screening questionnaire	Form	New	Repair queued
Temporary housing unit occupant - Main questionnaire	Form	New	Repair queued
Temporary housing unit occupant - screening questionnaire	Form	New	Repair queued
Supporting Statement Section B 11 04 09.doc	Supporting Statement B	Uploaded 2009-12-14	Repair queued
Appendix K IRB Approval Letter 11 04 09.doc	Supplementary Document	Uploaded 2009-12-14	Repair queued
Appendix F Letter Intro Trailer Occupants 11 04 09.doc	Supplementary Document	Uploaded 2009-12-14	Repair queued
Appendix E Media Outreach-Web 11 04 09.doc	Supplementary Document	Uploaded 2009-12-14	Repair queued
Appendix D Media Outreach Radio Ad 11 04 09.doc	Supplementary Document	Uploaded 2009-12-14	Repair queued
Appendix C Access Controls 11 04 09.doc	Supplementary Document	Uploaded 2009-12-14	Repair queued
Attachment B 60-day Federal Register Notice 11 04 09.pdf	Supplementary Document	Uploaded 2009-12-14	Repair queued
Appendix A Authorizing Legislation 11 04 09.doc	Supplementary Document	Uploaded 2009-12-14	Repair queued
Supporting Statement Section A 11 04 09 REV (3).docx	Supporting Statement A	Uploaded 2009-12-14	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
191848	Non-temporary housing unit occupant - main questionnaire	Form	New
191847	Non-temporary housing unit occupant - screening questionnaire	Form	New
191846	Temporary housing unit occupant - Main questionnaire	Form	New
191845	Temporary housing unit occupant - screening questionnaire	Form	New

ICR Details

OMB Control No:	ICR Reference No: 201001-0923-001
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: HHS/TSDR	Agency Tracking No:
Title: Registration of Individuals Displaced by the Hurricanes Katrina and Rita
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn	Conclusion Date: 06/22/2010
	Date Received in OIRA: 01/25/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		24 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: We propose to develop a pilot registry to determine the feasibility and estimate costs of a registry of people displaced after hurricanes Katrina and Rita. It will include a sample of persons who occupied FEMA supplied temporary housing and a smaller sample of persons who did not reside in temporary housing units. It will serve as a basis for short and long term health surveillance, and be used to set research priorities.

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Authorizing Statute(s): US Code: 42 USC 104i Name of Law: CERCLA
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 16874	04/13/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 66364	12/15/2009
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Non-temporary housing unit occupant - main questionnaire	none	Non-temporary housing unit occupant - main questionnaire
Temporary housing unit occupant - screening questionnaire	none	Trailer Occupant - screener
Temporary housing unit occupant - Main questionnaire	none	Temporary housing occupant - main questionnaire
Non-temporary housing unit occupant - screening questionnaire	none	Non-temporary housing unit occupant - screener

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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: This is a new ICR.

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Annual Cost to Federal Government: $1,726,771

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

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? 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]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 01/25/2010

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