Domestic TB Manifest Template or Informal Manifest Request

Airline and Traveler Information Collection: Domestic Manifests and the Passenger Locator Form (42 CFR Part 70 and 71)

Documents and Forms

Document Name Document Type
Form 0920-1181 Domestic TB Manifest Template or Informal Manifest Request Form and Instruction
0920-1181 Domestic Manifest Template Attachment 5_Domestic_Manifest_Order_OMB 0920-1181.docx Form and Instruction
0920-1181 Domestic Manifest Template Attachment 5_Domestic_Manifest_Order_OMB 0920-1181.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Domestic TB Manifest Template or Informal Manifest Request	Agency IC Tracking Number:	0920-1181

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	0920-1181	Domestic Manifest Template	Attachment 5_Domestic_Manifest_Order_OMB 0920-1181.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	500	498	2
Annual IC Time Burden (Hours)	3,000	2,988	12
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.