Information Collection

Traveler 3rd Party Disclosure - Proof of a negative COVID-19 test

IC 245117 under ICR 202012-0920-017 · OMB 0920-1315.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Traveler 3rd Party Disclosure - Proof of a negative COVID-19 test	Form
Order - Requirement For Proof Of Negative Covid-19 Test Attachment A1 UK Airline Testing Order.pdf	Form
PASSENGER DISCLOSURE AND ATTESTATION FORM Attachment C - UK Passenger disclosure and attestation 28DEC2020.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	NA	Order - Requirement For Proof Of Negative Covid-19 Test Result For All Airline Passengers Arriving Into The United States from The United Kingdom	Attachment A1 UK Airline Testing Order.pdf	NA	Yes	Yes	Fillable Fileable
Form and Instruction	NA	PASSENGER DISCLOSURE AND ATTESTATION FORM	Attachment C - UK Passenger disclosure and attestation 28DEC2020.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Emergency Response

Privacy Act System of Records

Title: 09-20-0171 - Quarantine-and-Traveler-Related Activities

FR Citation: 72 FR 70867

Number of Respondents: 247,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	247,000	247,000
Annual IC Time Burden (Hours)	494,000	494,000
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.