Form 0920-20HF US Traveler health Declaration Web

2019 Novel Coronavirus Airport Entry Questionnaires

Attachment C COVID-2019 Web Format - U.S. Traveler Health Declaration.3.3.2020

United States Traveler Health Declaration

OMB: 0920-1287

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Form Approved
OMB Control No.0920-XXXX
Exp XX/XX/XXXX

This data collection is mandatory. Public reporting burden of this collection of information is estimated to average 15 minutes per response, including the
time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection
of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently
valid OMB Control Number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA 0920-XXXX


File Typeapplication/pdf
AuthorAmber Stolp
File Modified2020-03-04
File Created2020-03-03

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