COVID-2019 Referral Slip

2019 Novel Coronavirus Airport Entry Questionnaires

OMB: 0920-1287

IC ID: 239870

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

COVID-2019 Referral Slip 0920-20HF
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-20HF Referral Slip Attachment I COVID-2019 Referral Slip-2.10.2020_Final.docx No   Paper Only

Health Public Health Monitoring

 

640,000 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 640,000 0 -6,155,000 0 0 6,795,000
Annual IC Time Burden (Hours) 53,333 0 -512,917 0 0 566,250
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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