Information Collection

Quarantine Release

IC 206054 under ICR 201705-0920-008 · OMB 0920-0263.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0263 can be found here:

2020-08-14 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 3 42 CFR 71.53.pdf	Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Quarantine Release

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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
Instruction			Attachment 3 42 CFR 71.53.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

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 Part 70-71

FR Citation: 72 FR 70867

Number of Respondents: 24

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	144	-6	150
Annual IC Time Burden (Hours)	36	-2	38
Annual IC Cost Burden (Dollars)	1,620	1,620	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.