Information Collection

Att K_Rubella Aircraft Contact Investigation Outcome Reporting

IC 212222 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 K_Rubella Aircraft Contact Investigation Outcome Reporting	Form
0920-0900 Rubella Aircraft Contact Investigation Outcome Reporting Att. K-Rubella Aircraft Contact Investigation Outcome Reporting Form_final.PDF	Form
0920-0900 Rubella Aircraft Contact Investigation Outcome Reporting Att. K-Rubella Aircraft Contact Investigation Outcome Reporting Form_final.PDF	Form

IC Title:

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	Rubella Aircraft Contact Investigation Outcome Reporting	Att. K-Rubella Aircraft Contact Investigation Outcome Reporting Form_final.PDF		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Quarantine and Traveler-Related Activities, Including Records for Contact Tracing, Investigation, and Notification under 42 CFR 70 and 71

FR Citation: 72 FR 70867

Number of Respondents: 1

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	1	-26	27
Annual IC Time Burden (Hours)	0	-2	2
Annual IC Cost Burden (Dollars)	0	-84	84

Documents for IC

table that charts IC Documents
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.