Information Collection Request

Report of Illness or Death: Interstate Travel of Persons (42 CFR part 70)

ICR 201810-0920-002 · OMB 0920-0488 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-0488 42 CFR 70.11 Report of death or illness onboard aircraft operated by airline Form and Instruction New Available
Passenger Locator Form (Domestic) Form Removed Available
Form 0920-0488 42 CFR 70.4 - Report by the master of a vessel or person in charge of conveyance of the incidence of a communicable disease occurring while in interstate travel Form and Instruction Modified Available
Attachment 5 - Non-research determination.pdf Supplementary Document Uploaded 2018-11-13 Available
Attachment 4 - Privacy Impact Assessment.pdf Supplementary Document Uploaded 2018-11-13 Available
Attachment 3 - CDC FAA Memorandum of Agreement.pdf Supplementary Document Uploaded 2018-11-13 Available
Attachment 2 - 60-day FRN.pdf Supplementary Document Uploaded 2018-11-13 Available
Interstate Travel_0920-0488_Supporting_Statement B_09252018.doc Supporting Statement B Uploaded 2018-11-13 Available
Interstate Travel_0920-0488_Supporting_Statement A_13NOV2018.doc Supporting Statement A Uploaded 2018-11-13 Available
Attachment 1C 42 CFR 70.pdf Supplementary Document Uploaded 2015-12-03 Available
Attachment 1B 42 CFR 71.pdf Supplementary Document Uploaded 2015-12-03 Available
Attachment 1A Section 361 of the Public Health Service Act (42 USC 264).pdf Supplementary Document Uploaded 2015-12-03 Available

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2021 36 Months From Approved 05/31/2019
200 0 1,000
23 0 90
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 200 1,000 0 0 -800 0
Annual Time Burden (Hours) 23 90 0 0 -67 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No