State/Local General Outcome Reporting (Air)

Contact Investigation Outcome Reporting Forms

OMB: 0920-0900

IC ID: 197945

Information Collection (IC) Details

View Information Collection (IC)

State/Local General Outcome Reporting (Air)
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form n/a General Contact Investigation Outcome Reporting Form - Air Attachment G-General Contact Investigation Outcome Reporting Form Air tr....pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

0920-0171 Quarantine and Traveler Related Activities, Including Records for Cpmtact Tracing Investigation and Notification under 42 CFR Parts 70 and 71  72 FR 70867

34 0
   
State, Local, and Tribal Governments
 
   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 34 0 0 0 0 34
Annual IC Time Burden (Hours) 3 0 0 0 0 3
Annual IC Cost Burden (Dollars) 106 0 0 0 0 106

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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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