Information Collection

Cruise Ship Measles Outcome Reporting - Maritime (Word & Excel)

IC 212221 under ICR 201407-0920-002 · OMB 0920-0900.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0900 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Cruise Ship Measles Outcome Reporting - Maritime (Word & Excel)	Form
Measles Maritime (Word) Attachment K - Measles Contact Investigation Outcome Reporting Form - Ma....docx	Form
Measles Maritime (Excel) Attachment L - Measles Contact Investigation Form - Maritime.xlsx	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Cruise Ship Measles Outcome Reporting - Maritime (Word & Excel)

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	Measles Maritime (Word)	Attachment K - Measles Contact Investigation Outcome Reporting Form - Ma....docx		Yes	Yes	Fillable Fileable
Form	none	Measles Maritime (Excel)	Attachment L - Measles Contact Investigation Form - Maritime.xlsx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Quarantine and Traveler-Related Activities, Including Records for Contact Tracing, Investigation, and Notification under 42 CFR Parts 70 and 71

FR Citation: 72 FR 70867

Number of Respondents: 126

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

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	126	126
Annual IC Time Burden (Hours)	11	11
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.