Information Collection

International TB Manifest Template

IC 225157 under ICR 202003-0920-014 · OMB 0920-1180.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1180 can be found here:

2023-06-29 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
International TB Manifest Template	Form and Instruction
ORDER OF THE CENTERS FOR DISEASE CONTROL AND PREVENTION, Attachment 5 International TB Manifest Template Order Proposed.doc	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

International TB Manifest Template

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	ORDER OF THE CENTERS FOR DISEASE CONTROL AND PREVENTION, DEPARTMENT OF HEALTH AND HUMAN SERVICES - International TB Manifest Template	Attachment 5 International TB Manifest Template Order Proposed.doc	NA	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title: 09-20-0171 - Quarantine- and Traveler-Related Activities, Including Records for Contact Tracing Investigation and Notification under 42 CFR Parts 70 and 71

FR Citation: 72 FR 70867

Number of Respondents: 67

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	-67	67
Annual IC Time Burden (Hours)	-402	402
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.