OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

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

OMB 0920-1181 ยท HHS/CDC.

OMB 0920-1181

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.

The latest form for Airline and Traveler Information Collection: Domestic Manifests and the Passenger Locator Form (42 CFR Part 70 and 71) expires 2027-05-31 and is listed under ICR 202403-0920-010.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0920-1181 Informal Manifest RequestForm and Instruction
Form 0920-1181 Public Health Passenger Locator Form: outbreak of public health significance* (international flights)Form and Instruction
Form 0920-1181 Public Health Passenger Locator Form_DOMESTICForm and Instruction
Form 0920-1181 Public Health Passenger Locator Form_INTERNATIONALForm and Instruction
Form 0920-1181 Domestic TB Manifest Template or Informal Manifest RequestForm and Instruction
Attachment 4A-Non-Research Determination_OMB 0920-1181_2015.pdf Supplementary Document
Attachment 10_System of Records Notice 09-20-0171_12.13.2007.pdf Supplementary Document
Attachment 9-Approval for Removal of Expiration Date.pdf Supplementary Document
Attachment 4B-Non-Research Determination_OMB 0920-1181_2024.pdf Supplementary Document
Attachment 2_60-Day Federal Register Notice_OMB 0920-1181_1.16.2024.pdf Supplementary Document
Attachment 3B_Privacy Impact Assessment.pdf Supplementary Document
Attachment 1B_42 CFR part 70 Authorizing Legislation.pdf Supplementary Document
Attachment 1A_Section 361 of the Public Health Service Act (42 USC 264).pdf Supplementary Document
Attachment 8 IATA Passenger Manifest Information Request Form.pdf Supplementary Document
Attachment 3 QARS Privacy Impact Assessment.pdf Supplementary Document
Attachment 4 CDC Nonresearch determination Letter.pdf Supplementary Document
Attachment 7 Cover_Letter_Template_Proposed Changes.docx Supplementary Document
Attachment 13 Approval for Removal of Expiration Date.pdf Supplementary Document
Attachment 14 System of Record Notice.pdf Supplementary Document
Attachment 1C 42 CFR part 70.pdf Supplementary Document
Attachment 1B 42 CFR part 71.pdf Supplementary Document
Attachment 13 System of Record Notice.pdf Supplementary Document
Attachment 12 Approval for Removal of Expiration Date.pdf Supplementary Document
Attachment 10 Receipt of manifest letter.doc Supplementary Document
Attachment 8 IATA Passenger Manifest Information Request Form.pdf Supplementary Document
Attachment 7 Order Cover Letter.doc Supplementary Document
Attachment 4 CDC Nonresearch determination Letter.pdf Supplementary Document
Attachment 3 QARS Privacy Impact Assessment.pdf Supplementary Document
Attach 2 PLF 60 day 9.2.16.pdf Supplementary Document
Attachment 1C 42 CFR part 70.pdf Supplementary Document
Attachment 1B 42 CFR part 71.pdf Supplementary Document
Attachment 1A Section 361 of the Public Health Service Act (42 USC 264).docx Supplementary Document
Supporting Statement B template _OMB 0920-1181.docxSupporting Statement B
Supporting Statement A template_OMB 0920-1181.docxSupporting Statement A
Informal Manifest Request Form and Instruction
Public Health Passenger Locator Form: outbreak of public health significance* (international flights) Form and Instruction
Public Health Passenger Locator Form_DOMESTIC Form and Instruction
Public Health Passenger Locator Form_INTERNATIONAL Form and Instruction
Domestic TB Manifest Template or Informal Manifest Request Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202403-0920-010 Revision of a currently approved collection 2024-03-21 Approved with change
202004-0920-009 Revision of a currently approved collection 2020-05-13
202003-0920-003 No material or nonsubstantive change to a currently approved collection 2020-03-04 Withdrawn and continue
201610-0920-015 Existing collection in use without an OMB Control Number 2016-11-08 Approved with change

OMB Details

Domestic TB Manifest Template or Informal Manifest Request

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
FormNameElectronic accessType
Form 0920-1181Domestic Manifest TemplateFillable FileableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.