Foreign Quarantine Regulations (42CFR71)

Forms and Documents

Document Name	Status
Form 42CFR 71.21(a) Att H_42CFR71.21(a )_ Maritime Conveyance Illness or Death Investigation Form (Sections 1-4) Form and Instruction	Unchanged
Form 0920-0134 COVID-2019 Supplemental Questionnaire Form and Instruction	New
Form 0920-0134 Enhanced Data Collection During COVID-19 Pandemic Form and Instruction	Modified
Land Travel Illness or Death Investigation Form Form	Unchanged
Form 42 CFR 71.21(a) Maritime Conveyance Illness or Death Investigation Form (Section 5) Form and Instruction	Unchanged
Cumulative Influenza/Influenza-Like Illness (ILI) Form Form and Instruction	Unchanged
Form 0920-0134 Air Travel Illness or Death Investigation Form Form and Instruction	Unchanged
Application for Permission to Import A Dog Inadequately Immunized Against Rabies Form and Instruction	Unchanged
Form CDC 75.37 (f.4.421 Att D_71.51(c)(2)_NOTICE TO OWNERS AND IMPORTERS OF DOGS: Requirement for Dog Confinement Form and Instruction	Unchanged
0920-0134 Nonsub Change Request_COVID_9.29.2020_DGMQ.docx Justification for No Material/Nonsubstantive Change	2020-09-30
0920-0134 Nonsub Change_COVID Cruise RedCap.docx Justification for No Material/Nonsubstantive Change	2020-07-24
0920-0134 Nonsub Change_COVID Cruise RedCap_DGMQ.docx Supplementary Document	2020-04-13
0920-0134 Nonsub Change_COVID Cruise_V2_20200407.docx Supplementary Document	2020-04-07
0920-0134 Nonsub Change_Dog permit.docx Justification for No Material/Nonsubstantive Change	2019-04-30
Attachment K - IRB Non-Research Determination.pdf Supplementary Document	2018-11-09
Attachment J Privacy Impact Assessment.pdf Supplementary Document	2018-11-09
Attachment B 60-day FRN.pdf Supplementary Document	2018-11-09
0920-0134 Foreign Quarantine Reg SSA_02272019.doc Supporting Statement A	2019-02-28
0920-0134 Foreign Quarantine Reg SSB.docx Supporting Statement B	2018-11-08

IC Document Collections

IC ID	Document Title	Status
6646	Att H_42CFR71.21(a )_ Maritime Conveyance Illness or Death Investigation Form (Sections 1-4) Form and Instruction	Unchanged
243826	COVID-2019 Supplemental Questionnaire Form and Instruction	New
241195	Enhanced Data Collection During COVID-19 Pandemic Form and Instruction	Modified
234020	Land Travel Illness or Death Investigation Form Form	Unchanged
234019	Maritime Conveyance Illness or Death Investigation Form (Section 5) Form and Instruction	Unchanged
234012	Cumulative Influenza/Influenza-Like Illness (ILI) Form Form and Instruction	Unchanged
233978	Air Travel Illness or Death Investigation Form Form and Instruction	Unchanged
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
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
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: 202009-0920-024
Status: Active	Previous ICR Reference No: 202007-0920-016
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0134-20SL
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: 12/03/2020
	Date Received in OIRA: 10/05/2020
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.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2022	03/31/2022	03/31/2022
Responses	1,085,652	0	1,083,352
Time Burden (Hours)	269,248	0	269,013
Cost Burden (Dollars)	6,557,184	0	6,557,184

---

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. CDC is requesting approval for a set of changes to the “Enhanced Data Collection During COVID-19 Pandemic” REDCap form to facilitate collection of the data from cruise ships under the extended No Sail Order of July 16, 2020 and an additional form.

---

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

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

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

---

Number of Information Collection (IC) in this ICR: 20

IC Title	Form No.	Form Name
Air Travel Illness or Death Investigation Form	0920-0134	Air Travel Illness or Death Investigation Form
Land Travel Illness or Death Investigation Form	none	Land Travel Illness or Death Investigation Form
Enhanced Data Collection During COVID-19 Pandemic	0920-0134	Enhanced Data Collection During COVID-19 Pandemic
Cumulative Influenza/Influenza-Like Illness (ILI) Form	none	Cumulative Influenza/Influenza-Like Illness (ILI) Form
Maritime Conveyance Illness or Death Investigation Form (Section 5)	42 CFR 71.21(a)	Maritime Conveyance Illness or Death Investigation Form (Section 5)
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
42CFR71.32(b)_Importer Documentation of Non Infectiousness (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
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
42CFR71.33(c) Report by Persons in Isolation or Surveillance ((no form))
42CFR71.52(d)_Turtle Importation Permits ((verbal, no form))
Att I_42CFR71.21(b)_Death/Illness Reports from Aircraft
42CFR71.56(a)(2)_African Rodents--Request for Exemption
42CFR71.55 & 71.32_Dead Bodies--Death Certificates
42CFR71.56(a)(iii)_Appeal (Importer)
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))
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
COVID-2019 Supplemental Questionnaire	0920-0134	Supplemental COVID-2019 Questionnaire

---

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	1,085,652	1,083,352	0	2,300	0	0
Annual Time Burden (Hours)	269,248	269,013	0	235	0	0
Annual Cost Burden (Dollars)	6,557,184	6,557,184	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: Slight increase due to adding an extra minute to one instrument and adding an additional instrument.

---

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

---

Common Form ICR:  No

---

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: 10/05/2020

---