Information Collection

Cruise COVID-19 Case Investigation Worksheet

IC 248855 under ICR 202108-0920-009 · OMB 0920-1335.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1335 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-1335 Cruise COVID-19 Case Investigation Worksheet Form
0920-1335 COVID-19 Case Investigation worksheet Case Investigation Worksheet_08062021.xlsx Form
0920-1335 COVID-19 Case Investigation worksheet Case Investigation Worksheet_08062021.xlsx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Cruise COVID-19 Case Investigation Worksheet	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0920-1335	COVID-19 Case Investigation worksheet	Case Investigation Worksheet_08062021.xlsx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.