Domestic non-TB Manifest Template and Informal Manifest Request

Airline and Traveler Information Collection: Domestic Manifests and the Passenger Locator Form (42 CFR Part 70 and 71)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1181 can be found here:

Documents and Forms

Document Name Document Type
Attachment 9 Informal manifest request template.doc Instruction
Attachment 6 Domestic Non-TB Manifest Template Order.doc Instruction

Information Collection (IC) Details

IC Title:	Domestic non-TB Manifest Template and Informal Manifest Request	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 42 CFR Foreign Quarantine Reg part 71 42 CFR Foreign Quarantine Reg part 70 42 CFR Public Health Service Act (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Attachment 9 Informal manifest request template.doc		Yes	Yes	Fillable Fileable
Instruction			Attachment 6 Domestic Non-TB Manifest Template Order.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title: Quarantine and Traveler Related Activities Including Records for Contact Tracing Investiagation and Notification	FR Citation: 72 FR 239

Number of Respondents: 28	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	28	28
Annual IC Time Burden (Hours)	168	168
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.