Foreign Quarantine Regulations

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 71 Attachment I Maritime Conveyance Cumulative Influenza Influenza-Like Ill...	Form and Instruction	Unchanged	Available
71.21 (a) Radio Report of Death/Illness Report from Ships	Form	Unchanged	Available
Form Attach G Attachment G CDC PGA Message Set Requested Data on Regulated Imports Rod...	Form and Instruction	Unchanged	Available
Form 71.32(b) Attachment A4 - 6 Code of Federal Regulations part 29.8(b)	Form and Instruction	Unchanged	Available
Form 71.56 Message Set for Importing African Rodents	Form and Instruction	Unchanged	Available
Form 71.51 Attachment E CDC PGA Message Set Requested Data on Regulated Imports dom...	Form and Instruction	Unchanged	Available
Form 2 Maritime Illness and Death Reporting System--Gastrointestinal Illness Report	Form	Unchanged	Available
Form 71.21(c) Attachment J 71.21c Gastrointestinal illnesses reports MIDRS screenshot	Form and Instruction	Unchanged	Available
Form 75.51 (b)(2) CDC f Attachment C CDC form 75 37 NOTICE TO OWNERS AND IMPORTERS OF DOGS Requ...	Form and Instruction	Unchanged	Available
Form 4 Public Health Passenger Locator Form	Form	Unchanged	Available
Form 4 Public Health Passenger Locator Form	Form and Instruction	Modified	Available
Non-substantive change_ 0920-0134_PLF.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2015-02-17	Available
0920-0134 Final Revision ITDS Supporting Statement A.doc	Supporting Statement A	Uploaded 2014-09-22	Available
Attachment I Maritime Conveyance Cumulative Influenza Influenza-Like Ill....pdf	Supplementary Document	Uploaded 2014-06-26	Available
0920-0134 Revision ITDS Supporting Statement B 06052014.docx	Supporting Statement B	Uploaded 2014-06-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
6646	Maritime Conveyance Operators	Form and Instruction	Unchanged	Attachment I Maritime Conveyance Cumulative Influenza Influenza-Like Ill...
6646	Maritime Conveyance Operators	Form	Unchanged	71.21 (a) Radio Report of Death/Illness Report from Ships
212102	Importer/Filer CDC PGA Message Set for Importing African Rodent and all Family Viverridae Products	Form and Instruction	Unchanged	Attachment G CDC PGA Message Set Requested Data on Regulated Imports Rod...
212101	Importer Documentation of Non Infectiousness (no form; authorithy under 71.32 (b)	Form and Instruction	Unchanged	Attachment A4 - 6 Code of Federal Regulations part 29.8(b)
212100	Importer/Filer CDC PGA Message Set for Importing African Rodents	Form and Instruction	Unchanged	Message Set for Importing African Rodents
212099	Importer/Filer CDC Message Set for Importing Cats and Dogs	Form and Instruction	Unchanged	Attachment E CDC PGA Message Set Requested Data on Regulated Imports dom...
202077	Appeal (Importer) Title 71.56 (a)(iii)		Unchanged
202076	Dead Bodies--Death Certificates Title 71.55		Unchanged
202075	African Rodents--Request for Exemption Title 71.56 (a)(2)		Unchanged
202074	Recordkeeping--Medical Logs (Maritime), Title 71.21 (c)	Form	Unchanged	Maritime Illness and Death Reporting System--Gastrointestinal Illness Report
202073	Gastrointestinal Illness Reports 24 and 4 hours before Arrival (VSP) Title 71.21. (c)	Form and Instruction	Unchanged	Attachment J 71.21c Gastrointestinal illnesses reports MIDRS screenshot
202072	Death/Illness Reports from Aircraft Title 71.21 (b)	Other-Radio Report from aircraft commander	Unchanged
189698	71.52 Turtle Importation Permits		Unchanged
189697	Dogs/Cats: 71.51 (b)(2)Certification of confinement, vaccination, CDC form 75.37. Title 71.51(b)	Form and Instruction	Unchanged	Attachment C CDC form 75 37 NOTICE TO OWNERS AND IMPORTERS OF DOGS Requ...
189696	Importer Dogs/Cats: Record of Sickness or Deaths 71.51 (b)(3)		Unchanged
189695	Locator Form used for Reporting of an Ill Passenger(s) (Airport)	Form	Unchanged	Public Health Passenger Locator Form
189694	Passenger Locator Form used in a outbreak of public health significance	Form and Instruction	Modified	Public Health Passenger Locator Form
189693	71.35 Maritime Conveyance Operators Report of death/illness in port (verbal, no form)		Unchanged
189692	71.33(c) Isolated or Quarantined Individuals (Verbal, No form)		Unchanged

ICR Details

OMB Control No: 0920-0134	ICR Reference No: 201502-0920-010
Status: Historical Active	Previous ICR Reference No: 201406-0920-014
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: 02/24/2015
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/18/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2017	09/30/2017	09/30/2017
Responses	2,775,428	0	2,775,428
Time Burden (Hours)	235,579	0	235,579
Cost Burden (Dollars)	0	0	0

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Abstract: After reviewing operations undertaken during the Ebola response, CDC would like to change the respondent category for two forms.

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Authorizing Statute(s): Statute at Large: 42 Stat. 71
   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
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 15345	05/19/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 35161	06/19/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 18

table that charts list of burden

IC Title	Form No.	Form Name
71.33(c) Isolated or Quarantined Individuals (Verbal, No form)
71.35 Maritime Conveyance Operators Report of death/illness in port (verbal, no form)
71.52 Turtle Importation Permits
African Rodents--Request for Exemption Title 71.56 (a)(2)
Appeal (Importer) Title 71.56 (a)(iii)
Dead Bodies--Death Certificates Title 71.55
Death/Illness Reports from Aircraft Title 71.21 (b)
Dogs/Cats: 71.51 (b)(2)Certification of confinement, vaccination, CDC form 75.37. Title 71.51(b)	75.51 (b)(2) CDC form 75.37	Attachment C CDC form 75 37 NOTICE TO OWNERS AND IMPORTERS OF DOGS Requ...
Gastrointestinal Illness Reports 24 and 4 hours before Arrival (VSP) Title 71.21. (c)	71.21(c)	Attachment J 71.21c Gastrointestinal illnesses reports MIDRS screenshot
Importer Documentation of Non Infectiousness (no form; authorithy under 71.32 (b)	71.32(b)	Attachment A4 - 6 Code of Federal Regulations part 29.8(b)
Importer Dogs/Cats: Record of Sickness or Deaths 71.51 (b)(3)
Importer/Filer CDC Message Set for Importing Cats and Dogs	71.51	Attachment E CDC PGA Message Set Requested Data on Regulated Imports dom...
Importer/Filer CDC PGA Message Set for Importing African Rodent and all Family Viverridae Products	Attach G	Attachment G CDC PGA Message Set Requested Data on Regulated Imports Rod...
Importer/Filer CDC PGA Message Set for Importing African Rodents	71.56	Message Set for Importing African Rodents
Locator Form used for Reporting of an Ill Passenger(s) (Airport)	4	Public Health Passenger Locator Form
Maritime Conveyance Operators	none, 71	71.21 (a) Radio Report of Death/Illness Report from Ships ,   Attachment I Maritime Conveyance Cumulative Influenza Influenza-Like Ill...
Passenger Locator Form used in a outbreak of public health significance	4	Public Health Passenger Locator Form
Recordkeeping--Medical Logs (Maritime), Title 71.21 (c)	2	Maritime Illness and Death Reporting System--Gastrointestinal Illness Report

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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	2,775,428	2,775,428	0	0	0	0
Annual Time Burden (Hours)	235,579	235,579	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: $459,595

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: 02/18/2015

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