Foreign Quarantine Regulations (42CFR71)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 42CFR 71.21(a) Maritime Conveyance illness or Death Investigation Form	Form and Instruction	Unchanged	Available
Enhanced data collection during COVID-19 Pandemic - REDCap	Form and Instruction	Modified	Available
Enhanced Data Collection During COVID-19 Pandemic	Form and Instruction	Modified	Available
Land Travel Illness or Death Investigation Form	Form	Unchanged	Available
Form 42 CFR 71.21(a) Maritime Conveyance Illness or Death Investigation Form (Section 5)	Form and Instruction	Unchanged	Available
Cumulative Influenza/Influenza-Like Illness (ILI) Form	Form and Instruction	Unchanged	Available
Form 0920-0134 Air Travel Illness or Death Investigation Form	Form and Instruction	Unchanged	Available
Application for Permit to Import Dog Inadequately Immunized Against Rabies	Form and Instruction	Unchanged	Available
Permit to Conditionally Import a Dog Inadequately Immunized against Rabies - Single Entry	Form and Instruction	Unchanged	Available
Form CDC 75.37 (f.4.421 Notice to Owners and Importers of Dogs	Form and Instruction	Unchanged	Available
0920-0134 Nonsub Change_COVID Cruise RedCap_DGMQ.docx	Supplementary Document	Uploaded 2020-04-13	Available
0920-0134 Nonsub Change_COVID Cruise_V2_20200407.docx	Supplementary Document	Uploaded 2020-04-07	Available
0920-0134 Nonsub Change_Dog permit.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2019-04-30	Available
Attachment K - IRB Non-Research Determination.pdf	Supplementary Document	Uploaded 2018-11-09	Available
Attachment J Privacy Impact Assessment.pdf	Supplementary Document	Uploaded 2018-11-09	Available
Attachment B 60-day FRN.pdf	Supplementary Document	Uploaded 2018-11-09	Available
0920-0134 Foreign Quarantine Reg SSA_02272019.doc	Supporting Statement A	Uploaded 2019-02-28	Available
0920-0134 Foreign Quarantine Reg SSB.docx	Supporting Statement B	Uploaded 2018-11-08	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
6646	Att H_42CFR71.21(a )_ Maritime Conveyance Illness or Death Investigation Form (Sections 1-4)	Form and Instruction	Unchanged	Maritime Conveyance illness or Death Investigation Form
241195	Enhanced Data Collection During COVID-19 Pandemic	Form and Instruction	Modified	Enhanced data collection during COVID-19 Pandemic - REDCap
241195	Enhanced Data Collection During COVID-19 Pandemic	Form and Instruction	Modified	Enhanced Data Collection During COVID-19 Pandemic
234020	Land Travel Illness or Death Investigation Form	Form	Unchanged	Land Travel Illness or Death Investigation Form
234019	Maritime Conveyance Illness or Death Investigation Form (Section 5)	Form and Instruction	Unchanged	Maritime Conveyance Illness or Death Investigation Form (Section 5)
234012	Cumulative Influenza/Influenza-Like Illness (ILI) Form	Form and Instruction	Unchanged	Cumulative Influenza/Influenza-Like Illness (ILI) Form
233978	Air Travel Illness or Death Investigation Form	Form and Instruction	Unchanged	Air Travel Illness or Death Investigation Form
218789	42CFR71.51(c)(i)(ii)&(iii)_Exemption Criteria for the Importation of a Dog		Unchanged
218788	42CFR71.51(c )(1)(d)_Valid Rabies Vacinnation Certificates ((verbal, no form))		Unchanged
212101	42CFR71.32(b)_Importer Documentation of Non Infectiousness (no form)		Unchanged
212099	Application for Permission to Import A Dog Inadequately Immunized Against Rabies	Form and Instruction	Unchanged	Application for Permit to Import Dog Inadequately Immunized Against Rabies
212099	Application for Permission to Import A Dog Inadequately Immunized Against Rabies	Form and Instruction	Unchanged	Permit to Conditionally Import a Dog Inadequately Immunized against Rabies - Single Entry
202077	42CFR71.56(a)(iii)_Appeal (Importer)		Unchanged
202076	42CFR71.55 & 71.32_Dead Bodies--Death Certificates		Unchanged
202075	42CFR71.56(a)(2)_African Rodents--Request for Exemption		Unchanged
202072	Att I_42CFR71.21(b)_Death/Illness Reports from Aircraft		Unchanged
189698	42CFR71.52(d)_Turtle Importation Permits ((verbal, no form))		Unchanged
189697	Att D_71.51(c)(2)_NOTICE TO OWNERS AND IMPORTERS OF DOGS: Requirement for Dog Confinement	Form and Instruction	Unchanged	Notice to Owners and Importers of Dogs
189696	42CFR71.51(b)(3) Importer Dogs/Cats: Record of Sickness or Deaths ((verbal, no form))		Unchanged
189693	42CFR71.35_Report of Dealth Illness During Stay in Port ((verbal, no form))		Unchanged
189692	42CFR71.33(c) Report by Persons in Isolation or Surveillance ((no form))		Unchanged

ICR Details

OMB Control No: 0920-0134	ICR Reference No: 202004-0920-008
Status: Historical Active	Previous ICR Reference No: 202004-0920-003
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0134-20MV
Title: Foreign Quarantine Regulations (42CFR71)
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: 04/24/2020
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/14/2020
Terms of Clearance: Previous terms continue: OMB is approving this information collection request; the agency will request approval to extend or revise the collection if the agency seeks to continue the information collection activity beyond the approved period.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2022	03/31/2022	03/31/2022
Responses	1,093,752	0	1,093,752
Time Burden (Hours)	270,660	0	270,660
Cost Burden (Dollars)	6,624,662	0	6,624,662

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Abstract: The goal of this information collection is to facilitate a CDC public health mission as provided under the PHSA and Code of Federal Regulations. Collected information is intended to prevent the spread of communicable disease into and within the United States. The change request submitted in April 2020 added a new cruise ship reporting form that will solicit data concerning COVID-19 cases or potential COVID-19 cases; this request adds an electronic version to the recently approved reporting form.

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Authorizing Statute(s): US Code: 42 USC 264 Name of Law: Public Health Service Act
   Statute at Large: 42 Stat. 70
   Statute at Large: 42 Stat. 71
  

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:
	83 FR 45449	09/07/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 60870	11/27/2018
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 19

table that charts list of burden

IC Title	Form No.	Form Name
42CFR71.32(b)_Importer Documentation of Non Infectiousness (no form)
42CFR71.33(c) Report by Persons in Isolation or Surveillance ((no form))
42CFR71.35_Report of Dealth Illness During Stay in Port ((verbal, no form))
42CFR71.51(b)(3) Importer Dogs/Cats: Record of Sickness or Deaths ((verbal, no form))
42CFR71.51(c )(1)(d)_Valid Rabies Vacinnation Certificates ((verbal, no form))
42CFR71.51(c)(i)(ii)&(iii)_Exemption Criteria for the Importation of a Dog
42CFR71.52(d)_Turtle Importation Permits ((verbal, no form))
42CFR71.55 & 71.32_Dead Bodies--Death Certificates
42CFR71.56(a)(2)_African Rodents--Request for Exemption
42CFR71.56(a)(iii)_Appeal (Importer)
Air Travel Illness or Death Investigation Form	0920-0134	Air Travel Illness or Death Investigation Form
Application for Permission to Import A Dog Inadequately Immunized Against Rabies	none, none	Permit to Conditionally Import a Dog Inadequately Immunized against Rabies - Single Entry ,   Application for Permit to Import Dog Inadequately Immunized Against Rabies
Att D_71.51(c)(2)_NOTICE TO OWNERS AND IMPORTERS OF DOGS: Requirement for Dog Confinement	CDC 75.37 (f.4.421)	Notice to Owners and Importers of Dogs
Att H_42CFR71.21(a )_ Maritime Conveyance Illness or Death Investigation Form (Sections 1-4)	42CFR 71.21(a)	Maritime Conveyance illness or Death Investigation Form
Att I_42CFR71.21(b)_Death/Illness Reports from Aircraft
Cumulative Influenza/Influenza-Like Illness (ILI) Form	none	Cumulative Influenza/Influenza-Like Illness (ILI) Form
Enhanced Data Collection During COVID-19 Pandemic	n/a, none	Enhanced Data Collection During COVID-19 Pandemic ,   Enhanced data collection during COVID-19 Pandemic - REDCap
Land Travel Illness or Death Investigation Form	none	Land Travel Illness or Death Investigation Form
Maritime Conveyance Illness or Death Investigation Form (Section 5)	42 CFR 71.21(a)	Maritime Conveyance Illness or Death Investigation Form (Section 5)

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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	1,093,752	1,093,752	0	0	0	0
Annual Time Burden (Hours)	270,660	270,660	0	0	0	0
Annual Cost Burden (Dollars)	6,624,662	6,624,662	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: $1,601,872

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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? Yes

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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: 04/14/2020

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