Evaluation of Passengers from Japan

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Traveler Contact Information Form	Form	New	Available
Attachment B - 42 USC Section 243 - PHSA 311.rtf	Supplementary Document	Uploaded 2011-03-29	Available
Attachment A - 42 USC Section 241 - PHSA 301.rtf	Supplementary Document	Uploaded 2011-03-29	Available
Attachment E -List of Airports Receiving Direct Flights from Japan.pdf	Supplementary Document	Uploaded 2011-03-29	Available
Attachment D -Interim Recommendation for Evaluation of passengers from Japan03242011.pdf	Supplementary Document	Uploaded 2011-03-29	Available
Mini Supporting Statement -Evaluation of Passengers from Japan03 29 2011.docx	Supporting Statement A	Uploaded 2011-03-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
197104	Traveler Contact Information Form	Form	New

ICR Details

OMB Control No: 0920-0882	ICR Reference No: 201103-0920-010
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Evaluation of Passengers from Japan
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 03/31/2011
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/31/2011
	Date Received in OIRA: 03/30/2011
Terms of Clearance: Approved consistent with assurance from CDC that the data collection will not extend beyond the approved six months.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2011	6 Months From Approved
Responses	36	0	0
Time Burden (Hours)	6	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The CDC's National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) requests an emergency clearance to collect information to evaluate passengers from Japan due to the March 11, 2011 earthquake and tsunami.

Emergency Justfication: Emergency clearance is requested due to the earthquake and tsunami on March 11, 2011 in Japan which was an unanticipated event with potentially harmful health consequences.

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Authorizing Statute(s): US Code: 42 USC 243 Name of Law: Public Health Safety Act
   US Code: 42 USC 241 Name of Law: Public Health Service Act
  

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

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Traveler Contact Information Form	none	Traveler Contact Information Form

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ICR Summary of Burden

table that charts list of burden

	Total Approved	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	36	0	0	36	0	0
Annual Time Burden (Hours)	6	0	0	6	0	0
Annual Cost Burden (Dollars)	0	0	0	0	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: No

Burden Reduction Due to:

Short Statement: This is a new emergency clearance request.

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Annual Cost to Federal Government: $140

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

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? 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? 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: 03/30/2011

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