Att J_Measles Aircraft Contact Investigation Outcome Reporting Form

[NCEZID] Contact Investigation Outcome Reporting Forms

Documents and Forms

Document Name Document Type
Form 0920-0900 Att J_Measles Aircraft Contact Investigation Outcome Reporting Form Form
0920-0900 Measles Aircraft Contact Investigation Outcome Reporting Att. J-Measles Aircraft Contact Investigation Outcome Reporting Form_final.PDF Form
0920-0900 Measles Aircraft Contact Investigation Outcome Reporting Att. J-Measles Aircraft Contact Investigation Outcome Reporting Form_final.PDF Form

Information Collection (IC) Details

IC Title:	Att J_Measles 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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0920-0900	Measles Aircraft Contact Investigation Outcome Reporting Form	Att. J-Measles Aircraft Contact Investigation Outcome Reporting Form_final.PDF	NA	Yes	Yes	Fillable Fileable

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: 72	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	72	-1	73
Annual IC Time Burden (Hours)	6	0	6
Annual IC Cost Burden (Dollars)	0	-227	227

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.