Att J_42CFR71.21(c )_(MIDRS) Gastrointestinal Illness Report

Foreign Quarantine Regulations (42CFR71)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0134 can be found here:

Documents and Forms

Document Name Document Type
Form 42CFR71.21(c ) Att J_42CFR71.21(c )_(MIDRS) Gastrointestinal Illness Report Form
42CFR71.21(c ) (MIDRS) Gastrointestinal Illness Report Att J_42 CFR 71.21 (c ) (MIDRS) Gastrointestinal Illnesses reports.pdf Form

Information Collection (IC) Details

IC Title:	Att J_42CFR71.21(c )_(MIDRS) Gastrointestinal Illness Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 42 CFR Subpart C (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
Form	42CFR71.21(c )	(MIDRS) Gastrointestinal Illness Report	Att J_42 CFR 71.21 (c ) (MIDRS) Gastrointestinal Illnesses reports.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title: Quarantine and Traveler-Related Activities, Including Records for Tracing, Investigation and Notification under 42 CFR Parts 70 and 71	FR Citation: 72 FR 70867

Number of Respondents: 17,000	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	Previously Approved
Annual Number of Responses for this IC	17,000	17,000
Annual IC Time Burden (Hours)	850	850
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.