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Federal forms, ICRs, and supporting documents

Information Collection

Declaration Under Penalty Of Perjury For The Centers For Disease Control And Prevention's Temporary Halt In Evictions To Prevent Further Spread Of Covid-19

IC 243342 under ICR 202108-0920-014 · OMB 0920-1303.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form 0920-1303
Evictions Declaration 29DEC2020 DECLARATION UNDER PENALTY OF PERJURY FOR THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S TEMPORARY HALT IN EVICTIONS TO PREVENT FURTHER SPREAD OF COVID-19		 Form and Instruction
Form 0920-1303
Evictions Declaration 29DEC2020_Spanish DECLARATION UNDER PENALTY OF PERJURY FOR THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S TEMPORARY HALT IN EVICTIONS TO PREVENT FURTHER SPREAD OF COVID-19		 Form and Instruction
Form 0920-1303
Evictions Declaration 29JAN2021 DECLARATION UNDER PENALTY OF PERJURY FOR THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S TEMPORARY HALT IN EVICTIONS TO PREVENT FURTHER SPREAD OF COVID-19		 Form and Instruction
Form 0920-1303
Evictions Declaration - Spanish 29JAN2021 DECLARATION UNDER PENALTY OF PERJURY FOR THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S TEMPORARY HALT IN EVICTIONS TO PREVENT FURTHER SPREAD OF COVID-19		 Form and Instruction
Form 0920-1303
Evictions Declaration_Fillable PDF_508 DECLARATION UNDER PENALTY OF PERJURY FOR THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S TEMPORARY HALT IN EVICTIONS TO PREVENT FURTHER SPREAD OF COVID-19		 Form and Instruction
Form 0920-1303
Evictions Declaration_Fillable PDF_508 - Spanish DECLARATION UNDER PENALTY OF PERJURY FOR THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S TEMPORARY HALT IN EVICTIONS TO PREVENT FURTHER SPREAD OF COVID-19		 Form and Instruction
Form 0920-1303
Eviction Protection Declaration 29MAR2021 DECLARATION UNDER PENALTY OF PERJURY FOR THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S TEMPORARY HALT IN EVICTIONS TO PREVENT FURTHER SPREAD OF COVID-19		 Form and Instruction
Form 0920-1303
CDC Eviction Protection Declaration 07APR2021 DECLARATION UNDER PENALTY OF PERJURY FOR THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S TEMPORARY HALT IN EVICTIONS TO PREVENT FURTHER SPREAD OF COVID-19		 Form and Instruction
Form 0920-1303
CDC Eviction Protection Declaration 01JUL2021 - English DECLARATION UNDER PENALTY OF PERJURY FOR THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S TEMPORARY HALT IN EVICTIONS TO PREVENT FURTHER SPREAD OF COVID-19		 Form and Instruction
Form 0920-1303
Evictions Declaration 03AUG2021 DECLARATION UNDER PENALTY OF PERJURY FOR THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S TEMPORARY HALT IN EVICTIONS TO PREVENT FURTHER SPREAD OF COVID-19		 Form and Instruction
Evictions Declaration Final 28AUG2020.docx Instruction
Evictions Declaration Final 28AUG2020.docx Instruction
Evictions Declaration Final 28AUG2020_FINAL-Spanish.docx Instruction
Evictions Declaration Final 28AUG2020_FINAL-Spanish.docx Instruction
0920-1303 Evictions Declaration 29DEC2020
EvictionDeclaration_12.29.2020.docx 		Form and Instruction
0920-1303 Evictions Declaration 29DEC2020
EvictionDeclaration_12.29.2020.docx 		Form and Instruction
0920-1303 Evictions Declaration 29DEC2020_Spanish
EvictionDeclaration_12.29.2020-es.docx 		Form and Instruction
0920-1303 Evictions Declaration 29DEC2020_Spanish
EvictionDeclaration_12.29.2020-es.docx 		Form and Instruction
0920-1303 Evictions Declaration 29JAN2021
Eviction Declaration Form 1.29.21.docx 		Form and Instruction
0920-1303 Evictions Declaration 29JAN2021
Eviction Declaration Form 1.29.21.docx 		Form and Instruction
0920-1303 Evictions Declaration - Spanish 29JAN2021
EvictionDeclarationES 1.29.21.docx 		Form and Instruction
0920-1303 Evictions Declaration - Spanish 29JAN2021
EvictionDeclarationES 1.29.21.docx 		Form and Instruction
0920-1303 Evictions Declaration_Fillable PDF_508
322024_A_EvictionDeclare_508.pdf 		Form and Instruction
0920-1303 Evictions Declaration_Fillable PDF_508
322024_A_EvictionDeclare_508.pdf 		Form and Instruction
0920-1303 Evictions Declaration_Fillable PDF_508 - Spanish
322024_B_EvictionDeclare_esp_508.pdf 		Form and Instruction
0920-1303 Evictions Declaration_Fillable PDF_508 - Spanish
322024_B_EvictionDeclare_esp_508.pdf 		Form and Instruction
0920-1303 Eviction Protection Declaration 29MAR2021
CDC Eviction Declaration Form FINAL.docx 		Form and Instruction
0920-1303 Eviction Protection Declaration 29MAR2021
CDC Eviction Declaration Form FINAL.docx 		Form and Instruction
0920-1303 CDC Eviction Protection Declaration 07APR2021
Eviction Protection Declaration 08APR2021.pdf 		Form and Instruction
0920-1303 CDC Eviction Protection Declaration 07APR2021
Eviction Protection Declaration 08APR2021.pdf 		Form and Instruction
0920-1303 CDC Eviction Protection Declaration 01JUL2021 - English
English Declaration 6.24.pdf 		Form and Instruction
0920-1303 CDC Eviction Protection Declaration 01JUL2021 - English
English Declaration 6.24.pdf 		Form and Instruction
0920-1303 Evictions Declaration 03AUG2021
Revised CDC Declaration_08.03.2021 final.docx 		Form and Instruction
0920-1303 Evictions Declaration 03AUG2021
Revised CDC Declaration_08.03.2021 final.docx 		Form and Instruction
NewEvictionNotice_d1_Somali.PDF
CDC Evictions Protection Declaration - Somali		IC Document
NewEvictionNotice_d1_Somali.PDF
CDC Evictions Protection Declaration - Somali		IC Document
NewEvictionNotice_d1_Chinese Hong Kong.PDF
CDC Evictions Protection Declaration - Traditional Chinese		IC Document
NewEvictionNotice_d1_Chinese Hong Kong.PDF
CDC Evictions Protection Declaration - Traditional Chinese		IC Document
NewEvictionNotice_d1_Hindi.PDF
CDC Evictions Protection Declaration - Hindi		IC Document
NewEvictionNotice_d1_Hindi.PDF
CDC Evictions Protection Declaration - Hindi		IC Document
NewEvictionNotice_d1_Haitian Creole.PDF
CDC Evictions Protection Declaration - Haitian Creole		IC Document
NewEvictionNotice_d1_Haitian Creole.PDF
CDC Evictions Protection Declaration - Haitian Creole		IC Document
NewEvictionNotice_d1_Russian.PDF
CDC Evictions Protection Declaration - Russian		IC Document
NewEvictionNotice_d1_Russian.PDF
CDC Evictions Protection Declaration - Russian		IC Document
NewEvictionNotice_d1_Amharic.PDF
CDC Evictions Protection Declaration - Amharic		IC Document
NewEvictionNotice_d1_Amharic.PDF
CDC Evictions Protection Declaration - Amharic		IC Document
323605B_NewEvictionNotice__ESP_06292021.pdf
CDC Evictions Protection Declaration - Spanish		IC Document
323605B_NewEvictionNotice__ESP_06292021.pdf
CDC Evictions Protection Declaration - Spanish		IC Document
NewEvictionNotice_Arabic.PDF
CDC Evictions Protection Declaration - Arabic		IC Document
NewEvictionNotice_Arabic.PDF
CDC Evictions Protection Declaration - Arabic		IC Document
NewEvictionNotice_d1_Korean.PDF
CDC Evictions Protection Declaration - Korean		IC Document
NewEvictionNotice_d1_Korean.PDF
CDC Evictions Protection Declaration - Korean		IC Document
NewEvictionNotice_d1_Tagalog.PDF
CDC Evictions Protection Declaration - Tagalog		IC Document
NewEvictionNotice_d1_Tagalog.PDF
CDC Evictions Protection Declaration - Tagalog		IC Document
NewEvictionNotice_d1_Vietnamese.PDF
CDC Evictions Protection Declaration - Vietnamese		IC Document
NewEvictionNotice_d1_Vietnamese.PDF
CDC Evictions Protection Declaration - Vietnamese		IC Document
Eviction Declaration_Amharic.pdf
CDC Evictions Protection Declaration - Ahmeric 25AUG2021		IC Document
Eviction Declaration_Amharic.pdf
CDC Evictions Protection Declaration - Ahmeric 25AUG2021		IC Document
Eviction Declaration_Arabic.pdf
CDC Evictions Protection Declaration - Arabic 25AUG2021		IC Document
Eviction Declaration_Arabic.pdf
CDC Evictions Protection Declaration - Arabic 25AUG2021		IC Document
Eviction Declaration_Haitian Creole.pdf
CDC Evictions Protection Declaration - Haitian Creole 25AUG2021		IC Document
Eviction Declaration_Haitian Creole.pdf
CDC Evictions Protection Declaration - Haitian Creole 25AUG2021		IC Document
Eviction Declaration_Hindi.pdf
CDC Evictions Protection Declaration - Hindi 25AUG2021		IC Document
Eviction Declaration_Hindi.pdf
CDC Evictions Protection Declaration - Hindi 25AUG2021		IC Document
Eviction Declaration_Korean.pdf
CDC Evictions Protection Declaration - Korean 25AUG2021		IC Document
Eviction Declaration_Korean.pdf
CDC Evictions Protection Declaration - Korean 25AUG2021		IC Document
Eviction Declaration_Russian.pdf
CDC Evictions Protection Declaration - Russian 25AUG2021		IC Document
Eviction Declaration_Russian.pdf
CDC Evictions Protection Declaration - Russian 25AUG2021		IC Document
Eviction Declaration_Somali.pdf
CDC Evictions Protection Declaration - Somali 25AUG2021		IC Document
Eviction Declaration_Somali.pdf
CDC Evictions Protection Declaration - Somali 25AUG2021		IC Document
Eviction Declaration_Spanish.pdf
CDC Evictions Protection Declaration - Spanish 25AUG2021		IC Document
Eviction Declaration_Spanish.pdf
CDC Evictions Protection Declaration - Spanish 25AUG2021		IC Document
Eviction Declaration_Traditional Chinese.pdf
CDC Evictions Protection Declaration - Traditional Chinese 25AUG2021		IC Document
Eviction Declaration_Traditional Chinese.pdf
CDC Evictions Protection Declaration - Traditional Chinese 25AUG2021		IC Document
Eviction Declaration_Vietnamese.pdf
CDC Evictions Protection Declaration - Vietnamese 25AUG2021		IC Document
Eviction Declaration_Vietnamese.pdf
CDC Evictions Protection Declaration - Vietnamese 25AUG2021		IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

Information Collection Instruments:
table that charts list of instruments
Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction NA Yes Yes Fillable Fileable
Instruction NA Yes Yes Fillable Fileable
Form and Instruction 0920-1303 NA Yes Yes Fillable Fileable
Form and Instruction 0920-1303 NA Yes Yes Fillable Fileable
Form and Instruction 0920-1303 NA Yes Yes Fillable Fileable
Form and Instruction 0920-1303 NA Yes Yes Fillable Fileable
Form and Instruction 0920-1303 NA Yes Yes Fillable Fileable
Form and Instruction 0920-1303 NA Yes Yes Fillable Fileable
Form and Instruction 0920-1303 NA Yes Yes Fillable Fileable
Form and Instruction 0920-1303 NA Yes Yes Fillable Fileable
Form and Instruction 0920-1303 NA Yes Yes Fillable Fileable
Form and Instruction 0920-1303 NA Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 6,400,000 0 0 0 0 6,400,000
Annual IC Time Burden (Hours) 533,333 0 0 0 0 533,333
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
CDC Evictions Protection Declaration - Somali 07/01/2021
CDC Evictions Protection Declaration - Traditional Chinese 07/01/2021
CDC Evictions Protection Declaration - Hindi 07/01/2021
CDC Evictions Protection Declaration - Haitian Creole 07/01/2021
CDC Evictions Protection Declaration - Russian 07/01/2021
CDC Evictions Protection Declaration - Amharic 07/01/2021
CDC Evictions Protection Declaration - Spanish 07/01/2021
CDC Evictions Protection Declaration - Arabic 07/01/2021
CDC Evictions Protection Declaration - Korean 07/01/2021
CDC Evictions Protection Declaration - Tagalog 07/01/2021
CDC Evictions Protection Declaration - Vietnamese 07/01/2021
CDC Evictions Protection Declaration - Ahmeric 25AUG2021 08/25/2021
CDC Evictions Protection Declaration - Arabic 25AUG2021 08/25/2021
CDC Evictions Protection Declaration - Haitian Creole 25AUG2021 08/25/2021
CDC Evictions Protection Declaration - Hindi 25AUG2021 08/25/2021
CDC Evictions Protection Declaration - Korean 25AUG2021 08/25/2021
CDC Evictions Protection Declaration - Russian 25AUG2021 08/25/2021
CDC Evictions Protection Declaration - Somali 25AUG2021 08/25/2021
CDC Evictions Protection Declaration - Spanish 25AUG2021 08/25/2021
CDC Evictions Protection Declaration - Traditional Chinese 25AUG2021 08/25/2021
CDC Evictions Protection Declaration - Vietnamese 25AUG2021 08/25/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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