Information Collection

Passenger (airport check-in or gate agent) "Acknowledgement" and collection of information from passengers

IC 250111 under ICR 202205-0920-009 · OMB 0920-1354.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Passenger (airport check-in or gate agent) "Acknowledgement" and collection of information from passengers	Form
Passenger “Acknowledgement” and collection of informatio Attachment 4 Passenger “Acknowledgement” and collection of information from passengers.docx	Form
Passenger “Acknowledgement” and collection of informatio Attachment 4 Passenger “Acknowledgement” and collection of information from passengers.docx	Form
0920-1354 Requirement for Airlines and Operators to Collect and Tr GCTO Acknowledgement_11302021.pdf	Form
0920-1354 Requirement for Airlines and Operators to Collect and Tr GCTO Acknowledgement_11302021.pdf	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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	Passenger âAcknowledgementâ and collection of information from passengers	Attachment 4 Passenger âAcknowledgementâ and collection of information from passengers.docx	NA	No		Fillable Fileable
Form	0920-1354	Requirement for Airlines and Operators to Collect and Transmit Designated Information for Passengers and Crew arriving into the U.S.; Requirement for Passengers to Provide Designate Information	GCTO Acknowledgement_11302021.pdf	NA	No		Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 09-20-0171 Quarantine- or Traveler-related Activities

FR Citation: 83 FR 6591

Number of Respondents: 6,150,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	6,150,000	6,150,000
Annual IC Time Burden (Hours)	205,000	205,000
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.