Information Collection

Air Passenger - Request Humanitarian Exemption to COVID-19 Test or Documentation of Recovery

IC 250020 under ICR 202111-0920-002 · OMB 0920-1318.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1318 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1318 Air Passenger - Request Humanitarian Exemption to COVID-19 Test or Documentation of Recovery	Form
0920-1318 Request Humanitarian Exemption to COVID-19 Test or Docum Attachment D-Humanitarian or Emergency Testing Exemption or Vaccination Exception.pdf	Form

IC Title:

Air Passenger - Request Humanitarian Exemption to COVID-19 Test or Documentation of Recovery

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	0920-1318	Request Humanitarian Exemption to COVID-19 Test or Documentation of Recovery	Attachment D-Humanitarian or Emergency Testing Exemption or Vaccination Exception.pdf	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 09-20-0171 Quarantine- and Traveler-related Activities8

FR Citation: 83 FR 6591

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)	1,000	1,000
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.