Influenza-like Illness Investigation Outcome Reporting Form - Maritime

Contact Investigation Outcome Reporting Forms

⚠️ Notice: This information collection may be referencing outdated material.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
Influenza-like Illness Investigation Outcome Reporting Form - Maritime Form
Influenza-like Illness Investigation Outcome Reporting F Attachment F ILI Outbreak Cruise EDC Form.docx Form

Information Collection (IC) Details

IC Title:	Influenza-like Illness Investigation Outcome Reporting Form - Maritime	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	n/a	Influenza-like Illness Investigation Outcome Reporting Form	Attachment F ILI Outbreak Cruise EDC Form.docx		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 Investigations	FR Citation: 72 FR 7086

Number of Respondents: 45	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	45	45
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	561	561

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.