Information Collection Request

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

ICR 202403-0920-010 · OMB 0920-1181 · Received in OIRA

Forms and Documents

Document Name	Status
Form 0920-1181 Informal Manifest Request Form and Instruction	Modified
Form 0920-1181 Public Health Passenger Locator Form: outbreak of public health significance* (international flights) Form and Instruction	Removed
Form 0920-1181 Public Health Passenger Locator Form_DOMESTIC Form and Instruction	Modified
Form 0920-1181 Public Health Passenger Locator Form_INTERNATIONAL Form and Instruction	Modified
Form 0920-1181 Domestic TB Manifest Template or Informal Manifest Request Form and Instruction	Modified
Attachment 4A-Non-Research Determination_OMB 0920-1181_2015.pdf Supplementary Document	2024-03-19
Attachment 10_System of Records Notice 09-20-0171_12.13.2007.pdf Supplementary Document	2024-03-19
Attachment 9-Approval for Removal of Expiration Date.pdf Supplementary Document	2024-03-19
Attachment 4B-Non-Research Determination_OMB 0920-1181_2024.pdf Supplementary Document	2024-03-19
Attachment 2_60-Day Federal Register Notice_OMB 0920-1181_1.16.2024.pdf Supplementary Document	2024-03-19
Attachment 3B_Privacy Impact Assessment.pdf Supplementary Document	2024-03-19
Attachment 1B_42 CFR part 70 Authorizing Legislation.pdf Supplementary Document	2024-03-19
Attachment 1A_Section 361 of the Public Health Service Act (42 USC 264).pdf Supplementary Document	2024-03-19
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
Supporting Statement B template _OMB 0920-1181.docx Supporting Statement B	2024-03-19
Supporting Statement A template_OMB 0920-1181.docx Supporting Statement A	2024-03-19

IC Document Collections

IC ID	Document Title	Status
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
241341	Public Health Passenger Locator Form_DOMESTIC Form and Instruction	Modified
241340	Public Health Passenger Locator Form_INTERNATIONAL Form and Instruction	Modified
241339	Domestic TB Manifest Template or Informal Manifest Request Form and Instruction	Modified

ICR Details

Status	Received in OIRA
Agency/Subagency	HHS/CDC
OMB Control No	0920-1181
Type of Information Collection	Revision of a currently approved collection
Previous ICR Reference No	202004-0920-009
Agency Tracking No	0920-1181
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31