Information Collection

Cruise Ship Measles Outcome Reporting - Maritime (Word & Excel)

IC 212221 under ICR 201712-0920-005 · OMB 0920-0900.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0900 can be found here:

Documents and Forms

Document Name Document Type
Cruise Ship Measles Outcome Reporting - Maritime (Word & Excel) Form
Measles Maritime (Word) Attachment K - Measles Contact Investigation Outcome Reporting Form - Ma....docx Form
Measles Maritime (Excel) Attachment L - Measles Contact Investigation Form - Maritime.xlsx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Cruise Ship Measles Outcome Reporting - Maritime (Word & Excel)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Measles Maritime (Word)	Attachment K - Measles Contact Investigation Outcome Reporting Form - Ma....docx		Yes	Yes	Fillable Fileable
Form	none	Measles Maritime (Excel)	Attachment L - Measles Contact Investigation Form - Maritime.xlsx		Yes	Yes	Fillable Fileable

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, and Notification under 42 CFR Parts 70 and 71	FR Citation: 72 FR 70867

Number of Respondents: 126	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	126	126
Annual IC Time Burden (Hours)	11	11
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.