Information Collection Request

[NCEZID] Contact Investigation Outcome Reporting Forms

ICR 202408-0920-006 · OMB 0920-0900 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-0900 Influenza Outbreak Enhanced Data Collection Form – Maritime Form and Instruction Modified Available
Form 0920-0900 Att G_Influenza Outbreak Enhanced Data Collection Form – Maritime Form and Instruction Modified Available
Form 0920-0900 Varicella Outbreak Enhanced Data Collection Form - Maritime Form Modified Available
Form 0920-0900 Att F_Varicella Outbreak Enhanced Data Collection Form - Maritime Form Modified Available
Form 0920-0900 Rubella Aircraft Contact Investigation Outcome Reporting Form Modified Available
Form 0920-0900 Att K_Rubella Aircraft Contact Investigation Outcome Reporting Form Modified Repair queued
Form 0920-0900 Measles Aircraft Contact Investigation Outcome Reporting Form Form Modified Available
Form 0920-0900 Att J_Measles Aircraft Contact Investigation Outcome Reporting Form Form Modified Repair queued
Form 0920-0900 TB Maritime Contact Investigation Worksheet Form Modified Available
Form 0920-0900 Att E_TB Maritime Contact Investigation Worksheet Form Modified Available
Form 0920-0900 General Land Contact Investigation Outcome Reporting Form Form Modified Available
Form 0920-0900 Att I_General Land Contact Investigation Outcome Reporting Form Form Modified Repair queued
Form 0920-0900 State/Local General Outcome Reporting Form Modified Available
Form 0920-0900 Att H_General Aircraft Contact Investigation Outcome Reporting Form Form Modified Repair queued
Form 0920-0900 General Land Contact Investigation Outcome Reporting Form Form Modified Available
Form 0920-0900 Att L_General Land Contact Investigation Outcome Reporting Form Form Modified Available
0920-0900 SupSta B_FINAL.docx Supporting Statement B Uploaded 2024-08-16 Repair queued
0920-0900 SupSta B_FINAL.docx Supporting Statement B Uploaded 2024-08-16 Available
0920-0900 SupSta A_FINAL_09.24.24.docx Supporting Statement A Uploaded 2024-09-25 Repair queued
0920-0900 SupSta A_FINAL_081924.docx Supporting Statement A Uploaded 2024-08-20 Available
Att. M-QARS_PIA_Signed_2022-07-29.pdf Supplementary Document Uploaded 2024-08-12 Available
Att. M-QARS_PIA_Signed_2022-07-29.pdf Supplementary Document Uploaded 2024-08-12 Repair queued
Att. D Non-researach Determination.pdf Supplementary Document Uploaded 2024-08-12 Available
Att. D Non-researach Determination.pdf Supplementary Document Uploaded 2024-08-12 Repair queued
Att. M-QARS_PIA.pdf Supplementary Document Uploaded 2024-08-12 Repair queued
Att. M-QARS_PIA.pdf Supplementary Document Uploaded 2024-08-12 Repair queued
Att. B-60 Day Federal Register Notice_0920-0900_6.4.2024.pdf Supplementary Document Uploaded 2024-08-12 Available
Att. B-60 Day Federal Register Notice_0920-0900_6.4.2024.pdf Supplementary Document Uploaded 2024-08-12 Repair queued
Att. A3-42 CFR part 71 Authorizing Legislation.pdf Supplementary Document Uploaded 2024-08-12 Repair queued
Att. A3-42 CFR part 71 Authorizing Legislation.pdf Supplementary Document Uploaded 2024-08-12 Repair queued
Att. A2-42 CFR part 70 Authorizing Legislation.pdf Supplementary Document Uploaded 2024-08-12 Available
Att. A2-42 CFR part 70 Authorizing Legislation.pdf Supplementary Document Uploaded 2024-08-12 Repair queued
Att. A1-Section 361 of the Public Health Service Act (42 USC 264).pdf Supplementary Document Uploaded 2024-08-08 Repair queued
Att. A1-Section 361 of the Public Health Service Act (42 USC 264).pdf Supplementary Document Uploaded 2024-08-08 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
231143 Att G_Influenza Outbreak Enhanced Data Collection Form – Maritime Form and Instruction ModifiedInfluenza Outbreak Enhanced Data Collection Form – Maritime
231143 Att G_Influenza Outbreak Enhanced Data Collection Form – Maritime Form and Instruction Modified
231142 Att F_Varicella Outbreak Enhanced Data Collection Form - Maritime Form ModifiedVaricella Outbreak Enhanced Data Collection Form - Maritime
231142 Att F_Varicella Outbreak Enhanced Data Collection Form - Maritime Form Modified
212222 Att K_Rubella Aircraft Contact Investigation Outcome Reporting Form ModifiedRubella Aircraft Contact Investigation Outcome Reporting
212222 Att K_Rubella Aircraft Contact Investigation Outcome Reporting Form Modified
197948 Att J_Measles Aircraft Contact Investigation Outcome Reporting Form Form ModifiedMeasles Aircraft Contact Investigation Outcome Reporting Form
197948 Att J_Measles Aircraft Contact Investigation Outcome Reporting Form Form Modified
197947 Att E_TB Maritime Contact Investigation Worksheet Form ModifiedTB Maritime Contact Investigation Worksheet
197947 Att E_TB Maritime Contact Investigation Worksheet Form Modified
197946 Att I_General Land Contact Investigation Outcome Reporting Form Form ModifiedGeneral Land Contact Investigation Outcome Reporting Form
197946 Att I_General Land Contact Investigation Outcome Reporting Form Form Modified
197945 Att H_General Aircraft Contact Investigation Outcome Reporting Form Form ModifiedState/Local General Outcome Reporting
197945 Att H_General Aircraft Contact Investigation Outcome Reporting Form Form Modified
197943 Att L_General Land Contact Investigation Outcome Reporting Form Form ModifiedGeneral Land Contact Investigation Outcome Reporting Form
197943 Att L_General Land Contact Investigation Outcome Reporting Form Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2027 36 Months From Approved 09/30/2024
235 0 16,890
33 0 1,423
0 0 53,136





Reginfo record details
8
table that charts list of burden
IC Title Form No. Form Name
Att J_Measles Aircraft Contact Investigation Outcome Reporting Form 0920-0900
Att E_TB Maritime Contact Investigation Worksheet 0920-0900
Att F_Varicella Outbreak Enhanced Data Collection Form - Maritime 0920-0900
Att G_Influenza Outbreak Enhanced Data Collection Form – Maritime 0920-0900
Att H_General Aircraft Contact Investigation Outcome Reporting Form 0920-0900
Att I_General Land Contact Investigation Outcome Reporting Form 0920-0900
Att K_Rubella Aircraft Contact Investigation Outcome Reporting 0920-0900
Att L_General Land Contact Investigation Outcome Reporting Form 0920-0900

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 235 16,890 0 -16,655 0 0
Annual Time Burden (Hours) 33 1,423 0 -1,390 0 0
Annual Cost Burden (Dollars) 0 53,136 0 -53,136 0 0


Reginfo record details
  No