Information Collection

CureTB Transnational Notification (TB patients referred by ICE)

IC 242057 under ICR 202402-0920-003 · OMB 0920-1186.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CS347315-A (02/01/ CureTB Transnational Notification (TB patients referred by ICE)	Form and Instruction
CS347315-A (02/01/ CureTB Transnational Notificaiton Att. C- CureTBTransnational Notification-v2-508.pdf	Form and Instruction
CS347315-A (02/01/ CureTB Transnational Notificaiton Att. C- CureTBTransnational Notification-v2-508.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

CureTB Transnational Notification (TB patients referred by ICE)

Agency IC Tracking Number:

0920-1186

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 and Instruction	CS347315-A (02/01/2024)	CureTB Transnational Notificaiton	Att. C- CureTBTransnational Notification-v2-508.pdf		No		Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title: 09-20-0171, Quarantine- and Traveler-related Activities Including Records for Contact Tracing Investigation and Notification under 42 CFR Parts 70 and 71

FR Citation: 72 FR 70867

Number of Respondents: 600

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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	600	13	587
Annual IC Time Burden (Hours)	450	10	440
Annual IC Cost Burden (Dollars)	0	-10,997	10,997

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.