Information Collection

Air Passenger - Section 1 of Combined Passenger Disclosure and Attestation to the United States of America

IC 250014 under ICR 202206-0920-006 · 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⚠️ Notice: This information collection may be referencing outdated material.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 - Section 1 of Combined Passenger Disclosure and Attestation to the United States of America	Form and Instruction
0920-1318 COMBINED PASSENGER DISCLOSURE AND ATTESTATION TO THE UNI Attachment C-Combined-Passenger-Attestation-10.30.2021.pdf	Form and Instruction
0920-1318 COMBINED PASSENGER DISCLOSURE AND ATTESTATION TO THE UNI Attachment A - Combined Passenger Attestation for Amended Testing Order-12.2.2021-Clean_.pdf	Form and Instruction
0920-1318 COMBINED PASSENGER DISCLOSURE AND ATTESTATION TO THE UNI Attachment A - CDC_Clean_Passenger Attestation_FINAL.pdf	Form and Instruction

IC Title:

Air Passenger - Section 1 of Combined Passenger Disclosure and Attestation to the United States of America

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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 and Instruction	0920-1318	COMBINED PASSENGER DISCLOSURE AND ATTESTATION TO THE UNITED STATES OF AMERICA	Attachment C-Combined-Passenger-Attestation-10.30.2021.pdf	na	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1318	COMBINED PASSENGER DISCLOSURE AND ATTESTATION TO THE UNITED STATES OF AMERICA 03DEC2021	Attachment A - Combined Passenger Attestation for Amended Testing Order-12.2.2021-Clean_.pdf	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1318	COMBINED PASSENGER DISCLOSURE AND ATTESTATION TO THE UNITED STATES OF AMERICA 29MAR2022	Attachment A - CDC_Clean_Passenger Attestation_FINAL.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 Activities

FR Citation: 83 FR 6591

Number of Respondents: 123,000,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-123,000,000	123,000,000
Annual IC Time Burden (Hours)	-246,000,000	246,000,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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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.