42 CFR 70.4 - Report by the master of a vessel or person in charge of conveyance of the incidence of a communicable disease occurring while in interstate travel

Report of Illness or Death: Interstate Travel of Persons (42 CFR part 70)

Documents and Forms

Document Name Document Type
Form 0920-0488 42 CFR 70.4 - Report by the master of a vessel or person in charge of conveyance of the incidence of a communicable disease occurring while in interstate travel Form and Instruction
0920-0488 42 CFR 70.4 - Report by the master of a vessel or person Attachment 6 Master of Vessel or Conveyance Illness Report 101712 (1).doc Form and Instruction
0920-0488 42 CFR 70.4 - Report by the master of a vessel or person Attachment 6 Master of Vessel or Conveyance Illness Report 101712 (1).doc Form and Instruction

Information Collection (IC) Details

IC Title:	42 CFR 70.4 - Report by the master of a vessel or person in charge of conveyance of the incidence of a communicable disease occurring while in interstate travel	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-0488	42 CFR 70.4 - Report by the master of a vessel or person in charge of conveyance of the incidence of a communicable disease occurring while in interstate travel	Attachment 6 Master of Vessel or Conveyance Illness Report 101712 (1).doc	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Quarantine and Traveler-Related Activities, Including Records for Contact Tracing, Investigation, and Notification Under 42CFR Parts 70 and 71 70	FR Citation: 72 FR 70867

Number of Respondents: 200	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	Previously Approved
Annual Number of Responses for this IC	200	190	10
Annual IC Time Burden (Hours)	23	22	1
Annual IC Cost Burden (Dollars)	0	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.