Information Collection

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

IC 212223 under ICR 201802-0920-005 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Cruise Ship Rubella Outcome Reporting - Maritime (Word & Excel)	Form
Rubella Maritime (Word) Attachment N - Rubella Contact Investigation Outcome Reporting Form - Ma....docx	Form
Rubella Maritime (Excel) Attachment O - Rubella Contact Investigation Outcome Reporting From - Ma....xlsx	Form

IC Title:

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

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Voluntary

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
Form	none	Rubella Maritime (Word)	Attachment N - Rubella Contact Investigation Outcome Reporting Form - Ma....docx		Yes	Yes	Fillable Fileable
Form	none	Rubella Maritime (Excel)	Attachment O - Rubella Contact Investigation Outcome Reporting From - Ma....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 70 and 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
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-24	24
Annual IC Time Burden (Hours)	-2	2
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.