Information Collection

Covid-19 Contact Tracing

IC 242419 under ICR 202006-1601-001 · OMB 1601-0027.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1601-0027 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
COVID-19 Contact Tracing Form.docx	Other-Mock Up
COVID-19 Contact Tracing Script- Interview of COVID POSITIVE DHS Personnel.docx	Other-Interview Script
COVID-19 Contact Tracing Notification Script- DHS Personnel.docx	Other-Notifiation Script

IC Title:

Covid-19 Contact Tracing

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Mock Up	COVID-19 Contact Tracing Form.docx	Yes	Yes	Fillable Fileable
Other-Interview Script	COVID-19 Contact Tracing Script- Interview of COVID POSITIVE DHS Personnel.docx	No		Fillable Fileable
Other-Notifiation Script	COVID-19 Contact Tracing Notification Script- DHS Personnel.docx	No		Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	167	167
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.