Information Collection

Ebola Entry Screening Risk Assessment - FRENCH

IC 214896 under ICR 201601-0920-011 · OMB 0920-0821.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Ebola Entry Screening Risk Assessment Form - French Ebola Entry Screening Risk Assessment - FRENCH	Form and Instruction
Ebola Entry Screening Risk Assessment Form - French Attachment G2 CDC Form Ebola Risk Assessment Trans Guide French.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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 and Instruction	None			None	No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Quarantine- and Traveler-Related Activities, Including Records for Contact Tracing Investigation

FR Citation: 72 FR 7086

Number of Respondents: 111

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-111	111
Annual IC Time Burden (Hours)	-28	28
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.

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