OMB control number

[CPR] U.S. National Authority for Containment of Poliovirus Data Collection Tools

OMB 0920-1424 ยท HHS/CDC.

OMB 0920-1424

In 2018, HHS designated the Centers for Disease Control and Prevention (CDC) as the National Authority for Containment of Poliovirus (U.S. NAC) for the United States. The U.S. NAC is located in the Center for Preparedness and Response (CPR). The role of the U.S. NAC is to ensure that the requirements established in the World Health Organization (WHO) Global Action Plan (GAP) III and IV standards are effectively implemented and maintained in poliovirus- essential facilities. Part of this standard includes emergency planning, the implementation of surveillance following an incident, and the reporting of facility-associated poliovirus events to the U.S. NAC. Risk assessments following an incident are a critical component for adequate application of the GAPIII/GAPIV standard and efficient emergency response. The goal of the project is to collect data in the event of a poliovirus breach of containment - as well as to understand the biosafety practices of facilities working on poliovirus and mitigations strategies in place to reduce risks. These goals are in line with World Health Organization's Global Action Plan (GAP) for Poliovirus containment efforts. This information will assist with meeting the goals of the Section 361 of the Public Health Service (PHS) Act (42 U.S.C. 264) and prevents the introduction, transmission, or spread of communicable diseases from foreign countries into the States or possessions, or from one State or possession into any other State or possession.

The latest form for [CPR] U.S. National Authority for Containment of Poliovirus Data Collection Tools expires 2029-01-31 and is listed under ICR 202509-0920-009.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0920-1424 Global Action Plan (GAP) Poliovirus Containment Poliovirus-Essential Facility QuestionnaireForm and Instruction
Form 0920-1424 Att 6_ Global Action Plan (GAP) Poliovirus Containment Poliovirus-Essential Facility QuestionnaireForm and Instruction
Form 0920-1424 Appeals and ComplaintsForm and Instruction
Form 0920-1424 AppealsForm and Instruction
Form 0920-1424 Facility Incident Reporting Form FOR POLIOVIRUS RELEASE or POTENTIAL EXPOSUREForm and Instruction
Form 0920-1424 Att 4_ Facility Incident Reporting Form FOR POLIOVIRUS THEFT or LOSSForm and Instruction
Form 0920-1424 Poliovirus Containment Sampling Points and Sanitation Assessment Form for Wastewater (WW) Systems Supporting a Poliovirus- Essential Facility (PEF) in the United StatesForm and Instruction
Form 0920-1424 Att 8- Poliovirus Containment Sampling Points and Sanitation Assessment Form for Wastewater (WW) Systems Supporting a Poliovirus- Essential Facility (PEF) in the United StatesForm and Instruction
Form 0920-1424 Personal Protective Equipment Survey for LaboratoriesForm and Instruction
Form 0920-1424 Att 7 _Personal Protective Equipment Survey for LaboratoriesForm and Instruction
Form 0920-1424 Facility Incident Reporting Form FOR POLIOVIRUS RELEASE or POTENTIAL EXPOSUREForm and Instruction
Form 0920-1424 Att 3_ Facility Incident Reporting Form FOR POLIOVIRUS RELEASE or POTENTIAL EXPOSUREForm and Instruction
ORR-NAC-30-Day Draft FRN_2025 Revision.docxSupplementary Document
ORR-NAC-30-Day Draft FRN_2025 Revision.docx Supplementary Document
Att 10 - Non-research determination.pdfSupplementary Document
Att 10 - Non-research determination.pdf Supplementary Document
Att 1b-OSH Act of 1977_29 USC 669 Section 20(a)(1)).pdfSupplementary Document
Att 1a - Federal Information Policy, 44 USC Sect. 3501.pdfSupplementary Document
Att 1a - Federal Information Policy, 44 USC Sect. 3501.pdf Supplementary Document
Att 9 -Non-research determination.pdfSupplementary Document
Att1b-OSH Act of 1977_29 USC 669 Section 20(a)(1)).pdfSupplementary Document
Att1a - Federal Information Policy, 44 USC Sect. 3501.pdfSupplementary Document
Att1a - Federal Information Policy, 44 USC Sect. 3501.pdf Supplementary Document
Att1 - Public Health Service Act, Section 2102_42 U.S.C. 300a-2.pdfSupplementary Document
SSB-ORR-NAC-0920-1424-25Revision_250916.docxSupporting Statement B
SSA-ORR-NAC-0920-1424-25Revision_250916_OIRA 12.29.25_clean.docxSupporting Statement A
SSA-ORR-NAC-0920-1424-25Revision_250916.docxSupporting Statement A
Att 6_ Global Action Plan (GAP) Poliovirus Containment Poliovirus-Essential Facility Questionnaire Form and Instruction
Att 6_ Global Action Plan (GAP) Poliovirus Containment Poliovirus-Essential Facility Questionnaire Form and Instruction
Appeals Form and Instruction
Appeals Form and Instruction
Att 4_ Facility Incident Reporting Form FOR POLIOVIRUS THEFT or LOSS Form and Instruction
Att 4_ Facility Incident Reporting Form FOR POLIOVIRUS THEFT or LOSS Form and Instruction
Att 8- Poliovirus Containment Sampling Points and Sanitation Assessment Form for Wastewater (WW) Systems Supporting a Poliovirus- Essential Facility (PEF) in the United States Form and Instruction
Att 8- Poliovirus Containment Sampling Points and Sanitation Assessment Form for Wastewater (WW) Systems Supporting a Poliovirus- Essential Facility (PEF) in the United States Form and Instruction
Att 7 _Personal Protective Equipment Survey for Laboratories Form and Instruction
Att 7 _Personal Protective Equipment Survey for Laboratories Form and Instruction
Att 3_ Facility Incident Reporting Form FOR POLIOVIRUS RELEASE or POTENTIAL EXPOSURE Form and Instruction
Att 3_ Facility Incident Reporting Form FOR POLIOVIRUS RELEASE or POTENTIAL EXPOSURE Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202509-0920-009 Revision of a currently approved collection 2025-11-24
202311-0920-001 New collection (Request for a new OMB Control Number) 2023-11-14 Approved without change

OMB Details

Att 3_ Facility Incident Reporting Form FOR POLIOVIRUS RELEASE or POTENTIAL EXPOSURE

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
FormNameElectronic accessType
Form 0920-1424Facility Incident Reporting Form FOR POLIOVIRUS RELEASE or POTENTIAL EXPOSUREFillable FileableForm and instruction

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