Daily Active Monitoring Tracking Report - excel

Emergency Submission for Active Monitoring of Travelers Coming from Ebola-affected Countries and Their Contacts Currently Residing in State, Territorial, and Local Jurisdictions

OMB: 0920-1066

IC ID: 215918

Information Collection (IC) Details

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Daily Active Monitoring Tracking Report - excel
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Direct Active Monitoring Tracking Report AttC - Daily DAM Recording High Some EVD Risk - Excel.xlsx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

25 0
   
State, Local, and Tribal Governments
 
   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 4,575 0 0 0 4,575 0
Annual IC Time Burden (Hours) 381 0 0 0 381 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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