Registration of Individuals Displaced by the Hurricanes Katrina and Rita (Pilot Project)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Questionnaire for temporary housing unit occupants	Form	New	Repair queued
Screening questionnaire for temporary housing unit occupants	Form	New	Repair queued
OMB Supporting Statement B Dec 8 2010 2.doc	Supporting Statement B	Uploaded 2011-03-21	Repair queued
OMB Appendix G IRB Continuation Approval-OSI Memo.docx	Supplementary Document	Uploaded 2011-03-21	Repair queued
OMB Appendix D Letter Intro Trailer Occupants Dec 2010.doc	Supplementary Document	Uploaded 2011-03-21	Repair queued
OMB Appendix C Access Controls Dec 8 2010.doc	Supplementary Document	Uploaded 2011-03-21	Repair queued
60 day FRN.pdf	Supplementary Document	Uploaded 2011-03-21	Repair queued
OMB Appendix A Authorizing Legislation July 2010.doc	Supplementary Document	Uploaded 2011-03-21	Repair queued
OMB Supporting Statement A Mar 17 2011.doc	Supporting Statement A	Uploaded 2011-03-21	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
197317	Questionnaire for temporary housing unit occupants	Form	New
197316	Screening questionnaire for temporary housing unit occupants	Form	New

ICR Details

OMB Control No:	ICR Reference No: 201104-0923-002
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 (Pilot Project)
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OIRA Conclusion Action: Withdrawn	Conclusion Date: 07/25/2011
	Date Received in OIRA: 04/14/2011
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: In 2005, Hurricanes Katrina and Rita struck the Gulf Coast. In the aftermath, some 375,000 persons occupied temporary housing units supplied by FEMA. Persons living in these units may have been exposed to levels of formaldehyde sufficient to arouse concern about the health impact. We propose to develop a pilot registry to serve as a comprehensive basis for short-term health surveillance, and allow FEMA and ATSDR to provide information to the affected population about health concerns and efforts to address those concerns. This registry will consist of people who occupied FEMA supplied temporary housing after hurricanes Katrina and Rita. CATI technology will be used to collect the data.

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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:
	76 FR 17867	03/31/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Screening questionnaire for temporary housing unit occupants	none	Screening questionnaire
Questionnaire for temporary housing unit occupants	none	Questionnaire

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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 resubmission of 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]? 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: 04/12/2011

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