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Public Health Passenger Locator Form_INTERNATIONAL
Airline and Traveler Information Collection: Domestic Manifests and the Passenger Locator Form (42 CFR Part 70 and 71)
OMB: 0920-1181
IC ID: 241340
OMB.report
HHS/CDC
OMB 0920-1181
ICR 202403-0920-010
IC 241340
( )
Documents and Forms
Document Name
Document Type
Form 0920-1181
Public Health Passenger Locator Form_INTERNATIONAL
Form and Instruction
0920-1181 Public Health Passenger Locator Form_INTERNATIONAL
Attachment 7_Public Health Passenger Locator Form.pdf
Form and Instruction
0920-1181 Public Health Passenger Locator Form_INTERNATIONAL
Attachment 7_Public Health Passenger Locator Form_revised.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Public Health Passenger Locator Form_INTERNATIONAL
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
0920-1181
Public Health Passenger Locator Form_INTERNATIONAL
Attachment 7_Public Health Passenger Locator Form_revised.pdf
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:
545
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
545
0
-255
0
0
800
Annual IC Time Burden (Hours)
45
0
-22
0
0
67
Annual IC Cost Burden (Dollars)
0
0
0
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.