Ebola Exposure Questionnaire for Airline Passengers

Contact Investigation Outcome Reporting Forms

OMB: 0920-0900

IC ID: 215017

Information Collection (IC) Details

View Information Collection (IC)

Ebola Exposure Questionnaire for Airline Passengers
 
No Removed
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None Ebola Exposure Questionnaire for Airline Passengers Attachment P ExposureQuestionnaire_Passengers.docx None Yes Yes Fillable Fileable

Health Public Health Monitoring

Quarantine- and Traveler-Related Activities  72 FR 7086

170 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 0 0 -340 0 0 340
Annual IC Time Burden (Hours) 0 0 -113 0 0 113
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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