Information Collection

Screening and Monitoring of DoD Personnel Deployed to Ebola Outbreak Areas

IC 213534 under ICR 201410-0720-001 · OMB 0720-0056.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0720-0056 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DD Form 2990 Screening and Monitoring of DoD Personnel Deployed to Ebola Outbreak Areas	Form
DD Form 2990 Ebola Virus Disease Exposure Risk Evaluation dd2990_10-22-14.pdf	Form
DD Form 2991 Ebola Virus Disease Redeployment Risk Assessment and Med dd2991_10-22-14.pdf	Form

IC Title:

Screening and Monitoring of DoD Personnel Deployed to Ebola Outbreak Areas

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

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	DD Form 2990	Ebola Virus Disease Exposure Risk Evaluation	dd2990_10-22-14.pdf		Yes	Yes	Fillable Fileable
Form	DD Form 2991	Ebola Virus Disease Redeployment Risk Assessment and Medical Clearance	dd2991_10-22-14.pdf		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,400	2,400
Annual IC Time Burden (Hours)	480	480
Annual IC Cost Burden (Dollars)	14,438	14,438

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.