Information Collection Request

Emergency Submission to Supplement OMB Control Number 0920-0821 in the context of Screening Travelers for Ebola Risk

ICR 201411-0920-008 · OMB 0920-1031 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-1031 United States Travel Health Declaration (Arabic: Hard Copy) Form and Instruction New Available
Form 0920-1031 United States Travel Health Declaration (French, Hard copy) Form and Instruction New Available
Form 0920-1031 United States Travel Health Declaration (English:hard copy, fillable PDF, electonic Portal) Form and Instruction New Available
Form 0920-1031 Ebola Risk Assessment for Travelers from Outbreak-affected Countries (French) Form and Instruction New Available
Form 0920-1031 Ebola Risk Assessment for Travelers from Outbreak-affected Countries (English) Form and Instruction New Available
Risk Assessment for Travelers from Ebola outreak-affected countries Form and Instruction Unchanged Available
United States Traveler Health Declaration - French Form and Instruction Unchanged Available
United States Traveler Health Declaration - English Form and Instruction Unchanged Available
Non-substantive Change 0920-1031 Em Change Supplment to 0821_Entry Screening - final.docx Justification for No Material/Nonsubstantive Change Uploaded 2014-11-19 Available
USCODE-2009-title42-chap6A-subchapII-partG.pdf Supplementary Document Uploaded 2014-10-10 Available
Attachment B DHS JobAid.docx Supplementary Document Uploaded 2014-10-10 Available
0920-0821 Emergency Request Entry Screening Part B.docx Supporting Statement B Uploaded 2014-10-10 Available
0920-0821 Emergency Request Entry Screening Part A.doc Supporting Statement A Uploaded 2014-10-10 Available

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
04/30/2015 04/30/2015 04/30/2015
88,420 0 55,380
22,106 0 13,845
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 88,420 55,380 0 33,040 0 0
Annual Time Burden (Hours) 22,106 13,845 0 8,261 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No