Foreign Quarantine Regulations

Forms and Documents

Document Name	Status
71.21 (a) Radio Report of Death/Illness Report from Ships Form	Modified
Form 2 Recordkeeping--Medical Logs (Maritime), Title 71.21 (c) Form	Modified
Form 2 Gastrointestinal Illness Reports 24 and 4 hours before Arrival (VSP) Title 71.21. (c) Form	Modified
Form 5 Dogs/Cats: Certification of confinement, vaccination, CDC form 75.37. Title 71.51(b) Form and Instruction	Modified
Form 4 Locator Form used for Reporting of an Ill Passenger(s) (Airport) Form	Modified
Form 4 Public Health Passenger Locator Form - Outbreak Aircraft Form and Instruction	Modified
Non-substantive change_Foreign Quarantine Regulations 0920-0134 05062013.doc Justification for No Material/Nonsubstantive Change	2013-05-06
Attachment 2 42 CFR 70 and 71.pdf Supplementary Document	2012-04-23
Attachment 5 Reportable Medical Conditions.docx Supplementary Document	2012-04-23
Attachment 2 42 CFR 70 and 71.pdf Supplementary Document	2012-04-23
Attachment 2 42 CFR 70 and 71.pdf Supplementary Document	2012-04-23

IC Document Collections

IC ID	Document Title	Status
6646	71.21 (a) Radio Report of Death/Illness Report from Ships Form	Modified
202077	Appeal (Importer) Title 71.56 (a)(iii)	Modified
202076	Dead Bodies--Death Certificates Title 71.55	Modified
202075	African Rodents--Request for Exemption Title 71.56 (a)(2)	Modified
202074	Recordkeeping--Medical Logs (Maritime), Title 71.21 (c) Form	Modified
202073	Gastrointestinal Illness Reports 24 and 4 hours before Arrival (VSP) Title 71.21. (c) Form	Modified
202072	Death/Illness Reports from Aircraft Title 71.21 (b) Other-Radio Report from aircraft commander	Modified
189698	71.52 Turtle Importation Permits	Modified
189697	Dogs/Cats: Certification of confinement, vaccination, CDC form 75.37. Title 71.51(b) Form and Instruction	Modified
189696	Dogs/Cats: Record of Sickness or Deaths 71.51 (b)(3)	Modified
189695	Locator Form used for Reporting of an Ill Passenger(s) (Airport) Form	Modified
189694	Public Health Passenger Locator Form - Outbreak Aircraft Form and Instruction	Modified
189693	71.35 Report of death/illness in port	Modified
189692	71.33(c) Report by person in isolation or surveillance	Modified

ICR Details

OMB Control No: 0920-0134	ICR Reference No: 201305-0920-003
Status: Historical Active	Previous ICR Reference No: 201304-0920-018
Agency/Subagency: HHS/CDC	Agency Tracking No: 19478
Title: Foreign Quarantine Regulations
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/13/2013
	Date Received in OIRA: 05/08/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2015	07/31/2015	07/31/2015
Responses	2,740,568	0	2,740,568
Time Burden (Hours)	227,263	0	227,263
Cost Burden (Dollars)	0	0	0

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Abstract: Section 361 of the Public Health Service Act (42 U.S.C. 264) authorizes the Secretary of Health and Human Services to make and enforce regulations necessary to prevent the introduction, transmission or spread of communicable diseases. This change request adds one cumulative reporting form and part of an approved form to simplify illness reporting.

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Authorizing Statute(s): Statute at Large: 42 Stat. 71 Name of Statute: null
   US Code: 42 USC 264 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: 14

IC Title	Form No.	Form Name
71.21 (a) Radio Report of Death/Illness Report from Ships	none, none	Maritime Conveyance Cumulative Influenza-Like Illness Form ,   Maritime Conveyance Illness or Death Investigation Form
71.33(c) Report by person in isolation or surveillance
71.35 Report of death/illness in port
Public Health Passenger Locator Form - Outbreak Aircraft	4	Public Health Passenger Locator Form
Locator Form used for Reporting of an Ill Passenger(s) (Airport)	4	Public Health Passenger Locator Form
Dogs/Cats: Record of Sickness or Deaths 71.51 (b)(3)
Dogs/Cats: Certification of confinement, vaccination, CDC form 75.37. Title 71.51(b)	5	Notice to Owners and Importers of Dogs
71.52 Turtle Importation Permits
Death/Illness Reports from Aircraft Title 71.21 (b)
Gastrointestinal Illness Reports 24 and 4 hours before Arrival (VSP) Title 71.21. (c)	2	Maritime Illness and Death Reporting System--Gastrointestinal Illness Report
Recordkeeping--Medical Logs (Maritime), Title 71.21 (c)	2	Maritime Illness and Death Reporting System--Gastrointestinal Illness Report
African Rodents--Request for Exemption Title 71.56 (a)(2)
Dead Bodies--Death Certificates Title 71.55
Appeal (Importer) Title 71.56 (a)(iii)

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ICR Summary 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	2,740,568	2,740,568	0	0	0	0
Annual Time Burden (Hours)	227,263	227,263	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $65,753

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: 05/08/2013

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