Information Collection

Cleaning Crew Assessment

IC 213515 under ICR 201410-0920-022 · OMB 0920-1032.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1032 can be found here:

2014-11-18 - No material or nonsubstantive change to a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Cleaning Crew Assessment	Form
Cleaning Crew Assessment Attachment D Ebola Airline Exposure Assessment Cleaning Crew_10-15-2014.doc	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Cleaning Crew Assessment

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	Cleaning Crew Assessment	Attachment D Ebola Airline Exposure Assessment Cleaning Crew_10-15-2014.doc		No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

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

FR Citation: 72 FR 70867

Number of Respondents: 600

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,200	1,200
Annual IC Time Burden (Hours)	400	400
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.