Airline and Traveler Information Collection: Domestic Manifests and the Passenger Locator Form (42 CFR Part 70 and 71)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-1181 Informal Manifest Request	Form and Instruction	Modified	Available
Form 0920-1181 Informal Manifest Request	Form and Instruction	Modified	Available
Form 0920-1181 Public Health Passenger Locator Form: outbreak of public health significance* (international flights)	Form and Instruction	Removed	Available
Form 0920-1181 Public Health Passenger Locator Form: outbreak of public health significance* (international flights)	Form and Instruction	Removed	Repair queued
Form 0920-1181 Public Health Passenger Locator Form_DOMESTIC	Form and Instruction	Modified	Available
Form 0920-1181 Public Health Passenger Locator Form_DOMESTIC	Form and Instruction	Modified	Repair queued
Form 0920-1181 Public Health Passenger Locator Form_INTERNATIONAL	Form and Instruction	Modified	Available
Form 0920-1181 Public Health Passenger Locator Form_INTERNATIONAL	Form and Instruction	Modified	Repair queued
Form 0920-1181 Domestic Manifest Template	Form and Instruction	Modified	Available
Form 0920-1181 Domestic TB Manifest Template or Informal Manifest Request	Form and Instruction	Modified	Repair queued
Attachment 4A-Non-Research Determination_OMB 0920-1181_2015.pdf	Supplementary Document	Uploaded 2024-03-19	Repair queued
Attachment 10_System of Records Notice 09-20-0171_12.13.2007.pdf	Supplementary Document	Uploaded 2024-03-19	Repair queued
Attachment 9-Approval for Removal of Expiration Date.pdf	Supplementary Document	Uploaded 2024-03-19	Repair queued
Attachment 4B-Non-Research Determination_OMB 0920-1181_2024.pdf	Supplementary Document	Uploaded 2024-03-19	Repair queued
Attachment 2_60-Day Federal Register Notice_OMB 0920-1181_1.16.2024.pdf	Supplementary Document	Uploaded 2024-03-19	Repair queued
Attachment 3B_Privacy Impact Assessment.pdf	Supplementary Document	Uploaded 2024-03-19	Repair queued
Attachment 1B_42 CFR part 70 Authorizing Legislation.pdf	Supplementary Document	Uploaded 2024-03-19	Repair queued
Attachment 1A_Section 361 of the Public Health Service Act (42 USC 264).pdf	Supplementary Document	Uploaded 2024-03-19	Repair queued
Attachment 8 IATA Passenger Manifest Information Request Form.pdf	Supplementary Document	Uploaded 2020-04-16	Repair queued
Attachment 3 QARS Privacy Impact Assessment.pdf	Supplementary Document	Uploaded 2020-04-15	Repair queued
Attachment 4 CDC Nonresearch determination Letter.pdf	Supplementary Document	Uploaded 2020-04-14	Repair queued
Attachment 7 Cover_Letter_Template_Proposed Changes.docx	Supplementary Document	Uploaded 2020-04-14	Repair queued
Attachment 13 Approval for Removal of Expiration Date.pdf	Supplementary Document	Uploaded 2020-04-14	Repair queued
Attachment 14 System of Record Notice.pdf	Supplementary Document	Uploaded 2020-04-14	Repair queued
Attachment 1C 42 CFR part 70.pdf	Supplementary Document	Uploaded 2020-04-14	Repair queued
Attachment 1B 42 CFR part 71.pdf	Supplementary Document	Uploaded 2020-04-14	Available
Attachment 13 System of Record Notice.pdf	Supplementary Document	Uploaded 2017-05-03	Repair queued
Attachment 12 Approval for Removal of Expiration Date.pdf	Supplementary Document	Uploaded 2016-11-02	Available
Attachment 10 Receipt of manifest letter.doc	Supplementary Document	Uploaded 2016-11-02	Repair queued
Attachment 8 IATA Passenger Manifest Information Request Form.pdf	Supplementary Document	Uploaded 2016-11-02	Repair queued
Attachment 7 Order Cover Letter.doc	Supplementary Document	Uploaded 2016-11-02	Repair queued
Attachment 4 CDC Nonresearch determination Letter.pdf	Supplementary Document	Uploaded 2016-10-31	Repair queued
Attachment 3 QARS Privacy Impact Assessment.pdf	Supplementary Document	Uploaded 2016-10-31	Repair queued
Attach 2 PLF 60 day 9.2.16.pdf	Supplementary Document	Uploaded 2016-10-31	Available
Attachment 1C 42 CFR part 70.pdf	Supplementary Document	Uploaded 2016-10-31	Repair queued
Attachment 1B 42 CFR part 71.pdf	Supplementary Document	Uploaded 2016-10-31	Repair queued
Attachment 1A Section 361 of the Public Health Service Act (42 USC 264).docx	Supplementary Document	Uploaded 2016-10-31	Available
Supporting Statement B template _OMB 0920-1181.docx	Supporting Statement B	Uploaded 2024-03-19	Repair queued
Supporting Statement A template_OMB 0920-1181.docx	Supporting Statement A	Uploaded 2024-03-19	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
241343	Informal Manifest Request	Form and Instruction	Modified	Informal Manifest Request
241343	Informal Manifest Request	Form and Instruction	Modified
241342	Public Health Passenger Locator Form: outbreak of public health significance* (international flights)	Form and Instruction	Removed	Public Health Passenger Locator Form: outbreak of public health significance* (international flights)
241342	Public Health Passenger Locator Form: outbreak of public health significance* (international flights)	Form and Instruction	Removed
241341	Public Health Passenger Locator Form_DOMESTIC	Form and Instruction	Modified	Public Health Passenger Locator Form_DOMESTIC
241341	Public Health Passenger Locator Form_DOMESTIC	Form and Instruction	Modified
241340	Public Health Passenger Locator Form_INTERNATIONAL	Form and Instruction	Modified	Public Health Passenger Locator Form_INTERNATIONAL
241340	Public Health Passenger Locator Form_INTERNATIONAL	Form and Instruction	Modified
241339	Domestic TB Manifest Template or Informal Manifest Request	Form and Instruction	Modified	Domestic Manifest Template
241339	Domestic TB Manifest Template or Informal Manifest Request	Form and Instruction	Modified

ICR Details

OMB Control No: 0920-1181	ICR Reference No: 202403-0920-010
Status: Active	Previous ICR Reference No: 202004-0920-009
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1181
Title: Airline and Traveler Information Collection: Domestic Manifests and the Passenger Locator Form (42 CFR Part 70 and 71)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/23/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/21/2024
Terms of Clearance: Previous terms of clearance continue to apply: Approved consistent with the understanding that an individual's refusal to be screened or to complete the passenger locator form will not directly result in that individual’s quarantine, isolation, or conditional release. However, if sufficient facts and circumstances exist that would lead a public health officer to reasonably suspect that the individual is infected with a quarantinable communicable disease in its qualifying stage, then that individual may be issued a Federal order for quarantine, isolation, or conditional surveillance.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2027	36 Months From Approved	05/31/2024
Responses	1,615	0	2,702,100
Time Burden (Hours)	3,240	0	228,134
Cost Burden (Dollars)	0	0	0

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Abstract: The goal of this information collection is to ensure that, consistent with the authorities in the Public Health Service Act and in Code of Federal Regulations (CFR), CDC can collect conveyance, passenger and crew member manifest information (aka manifests) and Passenger Locator Forms (PLF) in response to notification of an ill traveler who poses a risk to co-travelers, and that CDC can share useful contact information with health departments.

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Authorizing Statute(s): US Code: 42 USC 264 Name of Law: Public Health and Welfare
   Statute at Large: 42 Stat. 70 Name of Statute: Interstate Quarantine
   Statute at Large: 42 Stat. 71 Name of Statute: Foreign Quarantine
  

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:
	89 FR 2620	01/16/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 19591	03/19/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Domestic TB Manifest Template or Informal Manifest Request	0920-1181	Domestic Manifest Template
Informal Manifest Request	0920-1181	Informal Manifest Request
Public Health Passenger Locator Form: outbreak of public health significance* (international flights)	0920-1181	Public Health Passenger Locator Form: outbreak of public health significance* (international flights)
Public Health Passenger Locator Form_DOMESTIC	0920-1181	Public Health Passenger Locator Form_DOMESTIC
Public Health Passenger Locator Form_INTERNATIONAL	0920-1181	Public Health Passenger Locator Form_INTERNATIONAL

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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	1,615	2,702,100	0	-2,700,485	0	0
Annual Time Burden (Hours)	3,240	228,134	0	-224,894	0	0
Annual Cost Burden (Dollars)	0	0	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The Centers for Disease Control and Prevention (CDC), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), and Division of Global Migration Health (DGMH) are requesting to revise this information collection request. The total anticipated respondent burden associated with this information collection request is 3,240 hours.

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Annual Cost to Federal Government: $366,220

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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.     No

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? No

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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: 03/21/2024

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