Information Collection

Att H_General Aircraft Contact Investigation Outcome Reporting Form

IC 197945 under ICR 202408-0920-006 · OMB 0920-0900.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0900 Att H_General Aircraft Contact Investigation Outcome Reporting Form	Form
0920-0900 State/Local General Outcome Reporting Att. H-General Aircraft Contact Investigation Outcome Reporting Form_final.PDF	Form
0920-0900 State/Local General Outcome Reporting Att. H-General Aircraft Contact Investigation Outcome Reporting Form_final.PDF	Form

Information Collection (IC) Details

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IC Title:

Att H_General Aircraft Contact Investigation Outcome Reporting Form

Agency IC Tracking Number:

0920-0900

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	0920-0900	State/Local General Outcome Reporting	Att. H-General Aircraft Contact Investigation Outcome Reporting Form_final.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: 0920-0171 Quarantine and Traveler Related Activities, Including Records for Cpmtact Tracing Investigation and Notification under 42 CFR Parts 70 and 71

FR Citation: 72 FR 70867

Number of Respondents: 8

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	8	-16,664	16,672
Annual IC Time Burden (Hours)	1	-1,388	1,389
Annual IC Cost Burden (Dollars)	0	-51,850	51,850

Documents for IC

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