Information Collection

Cruise Ship Physician - Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form (submitted once per voyage, within 24 hours before arrival in U.S.)

IC 246878 under ICR 202310-0920-011 · OMB 0920-1335.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1335 can be found here:

2026-04-14 - Reinstatement with change of a previously approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Cruise Ship Physician - Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form (submitted once per voyage, within 24 hours before arrival in U.S.)	Form
Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form Cruise Ship Physician - Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form (submitted once per voyage, within 24 hours before arrival in U.S.)	Form
Form 0920-1335 Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form (submitted once per voyage, within 24 hours before arrival in U.S.) Cruise Ship Physician - Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form (submitted once per voyage, within 24 hours before arrival in U.S.)	Form
Cruise Ship Cumulative Acute Respiratory Illness (ARI) R Attachment H_ARI reporting_6.2.2023-clean.docx	Form
Cruise Ship Cumulative Acute Respiratory Illness (ARI) R Attachment H_ARI reporting_6.2.2023-clean.docx	Form
0920-1335 Cruise Ship Cumulative Acute Respiratory Illness (ARI) R AttachmentH_10232023.docx	Form
0920-1335 Cruise Ship Cumulative Acute Respiratory Illness (ARI) R AttachmentH_10232023.docx	Form
Attachment H_ARI reporting_6.2.2023-tracked.docx June 2023 edits (in tracked changes) to the Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form	IC Document
Attachment H_ARI reporting_6.2.2023-tracked.docx June 2023 edits (in tracked changes) to the Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Cruise Ship Physician - Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form (submitted once per voyage, within 24 hours before arrival in U.S.)

Agency IC Tracking Number:

0920-1335

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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	None	Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form	Attachment H_ARI reporting_6.2.2023-clean.docx		Yes	Yes	Fillable Fileable
Form	0920-1335	Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form (submitted once per voyage, within 24 hours before arrival in U.S.)	AttachmentH_10232023.docx	N/A	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	6,000	6,000
Annual IC Time Burden (Hours)	1,000	1,000
Annual IC Cost Burden (Dollars)	126,000	126,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
June 2023 edits (in tracked changes) to the Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form	Attachment H_ARI reporting_6.2.2023-tracked.docx	06/06/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.