Air Travel Illness or Death Investigation Form

Foreign Quarantine Regulations (42CFR71)

OMB: 0920-0134

IC ID: 233978

Information Collection (IC) Details

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Air Travel Illness or Death Investigation Form 0920-0134
 
No New
 
Voluntary
 
42 CFR 70 42 CFR 71

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0134 Air Travel Illness or Death Investigation Form Attachment C Air Travel Illness or Death Investigation Form final.docx NA No   Fillable Fileable

Health Public Health Monitoring

Quarantine and Traveler Related Activities, Including Records for Contact Tracing Investigation  72 FR 786

1,700 0
   
Individuals or Households
 
   0 %

  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 1,700 0 1,700 0 0 0
Annual IC Time Burden (Hours) 142 0 142 0 0 0
Annual IC Cost Burden (Dollars) 3,456 0 3,456 0 0 0

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