Contact Investigation Outcome Reporting Forms

ICR 202105-0920-009

OMB: 0920-0900

Federal Form Document

ICR Details
0920-0900 202105-0920-009
Received in OIRA 201808-0920-021
HHS/CDC 0920-0900
Contact Investigation Outcome Reporting Forms
Revision of a currently approved collection   No
Regular 05/28/2021
  Requested Previously Approved
36 Months From Approved 05/31/2021
16,890 1,036
1,423 109
53,136 4,055

The purpose of this information collection is to obtain sufficient information on the results of contact investigations carried out by state and local public health professionals or maritime medical crews to assess the impact of a confirmed communicable disease of public health concern in a traveler. Information is used to assess the impact in terms of spread and health outcomes and to determine if further public health intervention is appropriate. Communicable diseases of interest include clinically active tuberculosis (TB), varicella, influenza-like illness, measles, and rubella. The purpose of this Revision (submitted May 2021) is to update the estimated Burden in response to the COVID pandemic and to make minor modifications to several data collection forms.

US Code: 42 USC 70-71 Name of Law: Quarantine, Inspection, Licensing
   US Code: 42 USC 264 Name of Law: The Public Health and Welfare

Not associated with rulemaking

  86 FR 13390 03/08/2021
86 FR 28836 05/28/2021

  Total Request 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 16,890 1,036 0 15,854 0 0
Annual Time Burden (Hours) 1,423 109 0 1,314 0 0
Annual Cost Burden (Dollars) 53,136 4,055 0 49,081 0 0
Miscellaneous Actions
Miscellaneous Actions
Revision of 0920-0900 results in a net increased number of burden hours to account for changes made due to the COVID pandemic.

Yes Part B of Supporting Statement
Jeffrey Zirger 404 639-7118 [email protected]


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:
    (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;
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.

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