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42 CFR 70.11 Report of death or illness onboard aircraft operated by airline
Report of Illness or Death: Interstate Travel of Persons (42 CFR part 70)
OMB: 0920-0488
IC ID: 234025
OMB.report
HHS/CDC
OMB 0920-0488
ICR 201810-0920-002
IC 234025
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0488 can be found here:
2022-06-29 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 0920-0488
42 CFR 70.11 Report of death or illness onboard aircraft operated by airline
Form and Instruction
0920-0488 42 CFR 70.11 - Report of death or illness onboard aircra
Attachment 6 - 42 CFR 70.11 Cover Sheet.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
42 CFR 70.11 Report of death or illness onboard aircraft operated by airline
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
0920-0488
42 CFR 70.11 - Report of death or illness onboard aircraft operated by airline
Attachment 6 - 42 CFR 70.11 Cover Sheet.docx
NA
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
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 42CFR Parts 70 and 71 70
FR Citation:
72 FR 70867
Number of Respondents:
190
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
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
190
0
190
0
0
0
Annual IC Time Burden (Hours)
22
0
22
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
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.