Land Travel Illness or Death Investigation

Quarantine Station Illness Response Forms: Airline, Maritime, and Land/Border Crossing

OMB: 0920-0821

IC ID: 187999

Information Collection (IC) Details

View Information Collection (IC)

Land Travel Illness or Death Investigation
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Land Travel Illness or Death Investigation Attachment I Land Border investigation form 3_28_2012 FINAL.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

Quarantine and Traveler Related Activities, including Records for Contact Tracing Investigation and Notification  72 FR 70867

259 0
   
Private Sector Businesses or other for-profits
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 259 0 0 0 0 259
Annual IC Time Burden (Hours) 22 0 0 0 0 22
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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