Information Collection

Filovirus Specimen Submission

IC 206055 under ICR 201303-0920-003 · OMB 0920-0263.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0263 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Filovirus Specimen Submission	Form
Filovirus Attachment 7 Filovirus Diagnostic Specimen Submission Form for Non-human Primate Materials rev.docx	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Filovirus Specimen Submission

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Filovirus	Attachment 7 Filovirus Diagnostic Specimen Submission Form for Non-human Primate Materials rev.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title: 09-20-0171 Quarantine and Traveler Related Activities, Including Records for Contact Tracing, Investigation, and Notification Under 42 CFR Part 70-71

FR Citation: 72 FR 70867

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.