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

Forms and Documents

Document Name	Status
Form 0920-1181 Domestic Non-TB Manifest Template or Informal Manifest Request Form	New
Form 0920-1181 Public Health Passenger Locator Form: outbreak of public health significance* (international flights) Form and Instruction	New
Form 0920-1181 Public Health Passenger Locator Form: limited onboard exposure† (domestic flights) Form	New
Form 0920-1181 Public Health Passenger Locator Form: limited onboard exposure† (international flights Form	New
Form 0920-1181 Domestic TB Manifest Template or Informal Manifest Request Form and Instruction	New
Passenger Locator Form - domestic flights Form	Removed
Passenger Locator Form - limited onboard exposure int'l flights Form	Removed
Passenger Locator Form - outbreak of PH significance int'l flights Form	Removed
Attachment 8 IATA Passenger Manifest Information Request Form.pdf Supplementary Document	2020-04-16
Attachment 3 QARS Privacy Impact Assessment.pdf Supplementary Document	2020-04-15
Attachment 4 CDC Nonresearch determination Letter.pdf Supplementary Document	2020-04-14
Attachment 7 Cover_Letter_Template_Proposed Changes.docx Supplementary Document	2020-04-14
Attachment 13 Approval for Removal of Expiration Date.pdf Supplementary Document	2020-04-14
Attachment 14 System of Record Notice.pdf Supplementary Document	2020-04-14
Attachment 1C 42 CFR part 70.pdf Supplementary Document	2020-04-14
Attachment 1B 42 CFR part 71.pdf Supplementary Document	2020-04-14
Attachment 13 System of Record Notice.pdf Supplementary Document	2017-05-03
Attachment 12 Approval for Removal of Expiration Date.pdf Supplementary Document	2016-11-02
Attachment 10 Receipt of manifest letter.doc Supplementary Document	2016-11-02
Attachment 8 IATA Passenger Manifest Information Request Form.pdf Supplementary Document	2016-11-02
Attachment 7 Order Cover Letter.doc Supplementary Document	2016-11-02
Attachment 4 CDC Nonresearch determination Letter.pdf Supplementary Document	2016-10-31
Attachment 3 QARS Privacy Impact Assessment.pdf Supplementary Document	2016-10-31
Attach 2 PLF 60 day 9.2.16.pdf Supplementary Document	2016-10-31
Attachment 1C 42 CFR part 70.pdf Supplementary Document	2016-10-31
Attachment 1B 42 CFR part 71.pdf Supplementary Document	2016-10-31
Attachment 1A Section 361 of the Public Health Service Act (42 USC 264).docx Supplementary Document	2016-10-31
0920-1181_Domestic Manifest PLF Supporting Statement Part B.docx Supporting Statement B	2020-04-14
Revised 0920-1181_Domestic Manifest PLF SSA.docx Supporting Statement A	2020-05-13

IC Document Collections

IC ID	Document Title	Status
241343	Domestic Non-TB Manifest Template or Informal Manifest Request Form	New
241342	Public Health Passenger Locator Form: outbreak of public health significance* (international flights) Form and Instruction	New
241341	Public Health Passenger Locator Form: limited onboard exposure† (domestic flights) Form	New
241340	Public Health Passenger Locator Form: limited onboard exposure† (international flights Form	New
241339	Domestic TB Manifest Template or Informal Manifest Request Form and Instruction	New
224286	Passenger Locator Form - domestic flights Form	Removed
224285	Passenger Locator Form - limited onboard exposure int'l flights Form	Removed
224284	Passenger Locator Form - outbreak of PH significance int'l flights Form	Removed
224253	Domestic non-TB Manifest Template and Informal Manifest Request Instruction	Removed
224252	Domestic TB Manifest Template or Informal Manifest Request Instruction	Removed

ICR Details

OMB Control No: 0920-1181	ICR Reference No: 202004-0920-009
Status: Received in OIRA	Previous ICR Reference No: 201610-0920-015
Agency/Subagency: HHS/CDC	Agency Tracking No:
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	Date Submitted to OIRA: 05/13/2020

	Requested	Previously Approved
Expiration Date	36 Months From Approved	01/31/2021
Responses	2,702,100	2,701,629
Time Burden (Hours)	228,134	225,308
Cost Burden (Dollars)	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): Statute at Large: 42 Stat. 71 Name of Statute: Foreign Quarantine
   US Code: 42 USC 264 Name of Law: Public Health and Welfare
   Statute at Large: 42 Stat. 70 Name of Statute: Interstate 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:
	84 FR 59380	11/04/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 23357	04/27/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

IC Title	Form No.	Form Name
Domestic TB Manifest Template or Informal Manifest Request
Domestic non-TB Manifest Template and Informal Manifest Request
Domestic TB Manifest Template or Informal Manifest Request	0920-1181	Domestic TB Manifest Order Template
Passenger Locator Form - outbreak of PH significance int'l flights	none	Passenger Locator Form
Passenger Locator Form - limited onboard exposure int'l flights	none	Passenger Locator Form
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)
Passenger Locator Form - domestic flights	none	Passenger Locator Form
Public Health Passenger Locator Form: limited onboard exposure† (international flights	0920-1181	Public Health Passenger Locator Form: limited onboard exposure(international flights)
Public Health Passenger Locator Form: limited onboard exposure† (domestic flights)	0920-1181	Public Health Passenger Locator Form: limited onboard exposure(domestic flights)
Domestic Non-TB Manifest Template or Informal Manifest Request	0920-1181	Domestic Non-TB Manifest Order Template

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ICR Summary of Burden

	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	2,702,100	2,701,629	0	2,702,100	-2,701,629	0
Annual Time Burden (Hours)	228,134	225,308	0	228,134	-225,308	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: No

Burden Reduction Due to:

Short Statement: No increased burden is requested. CDC is asking for easily accessible information from airlines concerning crew contact information, a number of passengers on a flight, and where the crew worked during the flight to enhance risk analysis capabilities and determine which passengers need public health to follow up.

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Annual Cost to Federal Government: $818,871

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: 04/27/2020

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