Information Collection

Influenza-like Illness Investigation Outcome Reporting Form - Maritime

IC 231143 under ICR 202105-0920-009 · OMB 0920-0900.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0900 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Influenza-like Illness Investigation Outcome Reporting Form - Maritime	Form and Instruction
ILI Outbreak Enhanced Data Collection Att. F_ ILI Outbreak EDC_08 10 18.docx	Form and Instruction
ILI Outbreak Enhanced Data Collection Att. F_ ILI Outbreak EDC_08 10 18.docx	Form and Instruction

IC Title:

Influenza-like Illness Investigation Outcome Reporting Form - Maritime

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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	n/a	ILI Outbreak Enhanced Data Collection	Att. F_ ILI Outbreak EDC_08 10 18.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Quarantine- and Traveler-Related Activities, Including Records for Contact Tracing Investigations

FR Citation: 72 FR 7086

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	30	-15	45
Annual IC Time Burden (Hours)	10	-5	15
Annual IC Cost Burden (Dollars)	374	-187	561

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.