Information Collection

Noncitizen Nonimmigrant Air Passenger - PROOF OF COVID-19 VACCINATION FOR NONCITIZEN NONIMMIGRANTS PASSENGER DISCLOSURE AND ATTESTATION TO THE UNITED STATES OF AMERICA

IC 250017 under ICR 202206-0920-008 · 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⚠️ Notice: This information collection may be referencing outdated material.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 Noncitizen Nonimmigrant Air Passenger - PROOF OF COVID-19 VACCINATION FOR NONCITIZEN NONIMMIGRANTS PASSENGER DISCLOSURE AND ATTESTATION TO THE UNITED STATES OF AMERICA	Form
0920-1318 COMBINED PASSENGER DISCLOSURE AND ATTESTATION TO THE UNI Attachment C-Combined-Passenger-Attestation-10.30.2021.pdf	Form
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
0920-1318 COMBINED PASSENGER DISCLOSURE AND ATTESTATION TO THE UNI Attachment A - CDC_Clean_Passenger Attestation_FINAL.pdf	Form and Instruction
0920-1318 PROOF OF COVID-19 VACCINATION FOR NONCITIZEN NONIMMIGRAN PASSENGER DISCLOSURE AND ATTESTATION.docx	Form
0920-1318 PROOF OF COVID-19 VACCINATION FOR NONCITIZEN NONIMMIGRAN Attachment C-Proof of COVID-19 Vaccination For Noncitizen Nonimmigrants Passenger Disclosure and Attestation-6.11.2022.docx	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Noncitizen Nonimmigrant Air Passenger - PROOF OF COVID-19 VACCINATION FOR NONCITIZEN NONIMMIGRANTS PASSENGER DISCLOSURE AND ATTESTATION TO THE UNITED STATES OF AMERICA

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	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	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
Form	0920-1318	PROOF OF COVID-19 VACCINATION FOR NONCITIZEN NONIMMIGRANTS PASSENGER DISCLOSURE AND ATTESTATION TO THE UNITED STATES OF AMERICA	PASSENGER DISCLOSURE AND ATTESTATION.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1318	PROOF OF COVID-19 VACCINATION FOR NONCITIZEN NONIMMIGRANTS PASSENGER DISCLOSURE AND ATTESTATION TO THE UNITED STATES OF AMERICA 11JUN2022	Attachment C-Proof of COVID-19 Vaccination For Noncitizen Nonimmigrants Passenger Disclosure and Attestation-6.11.2022.docx	NA	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

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: 60,000,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	60,000,000	-30,000,000	90,000,000
Annual IC Time Burden (Hours)	60,000,000	-30,000,000	90,000,000
Annual IC Cost Burden (Dollars)	0	0	0

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table that charts IC Documents
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