International TB Manifest Template

Airline and Vessel and Traveler Information Collection (42 CFR Part 71)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1180 can be found here:

Documents and Forms

Document Name Document Type
International TB Manifest Template Form and Instruction
ORDER OF THE CENTERS FOR DISEASE CONTROL AND PREVENTION, Attachment 5 International TB Manifest Template Order Proposed.doc Form and Instruction

Information Collection (IC) Details

IC Title:	International TB Manifest Template	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	ORDER OF THE CENTERS FOR DISEASE CONTROL AND PREVENTION, DEPARTMENT OF HEALTH AND HUMAN SERVICES - International TB Manifest Template	Attachment 5 International TB Manifest Template Order Proposed.doc	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title: 09-20-0171 - Quarantine- and Traveler-Related Activities, Including Records for Contact Tracing Investigation and Notification under 42 CFR Parts 70 and 71	FR Citation: 72 FR 70867

Number of Respondents: 67	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	67	67
Annual IC Time Burden (Hours)	402	402
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.