Information Collection

Marburg Virus Disease Healthcare Worker Monitoring 2024

IC 271538 under ICR 202410-0920-023 · OMB 0920-1444.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Marburg Virus Disease Healthcare Worker Monitoring 2024	Form and Instruction
Marburg Virus Disease Healthcare Worker Monitoring 2024	Form and Instruction
Marburg Virus Disease Healthcare Worker Monitoring 2024 Attachment A - CDC Marburg Virus Disease Healthcare Worker Monitoring_NonSubChange_10.13.2024.docx	Form and Instruction
Marburg Virus Disease Healthcare Worker Monitoring 2024 Attachment A - CDC Marburg Virus Disease Healthcare Worker Monitoring_NonSubChange_10.13.2024.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

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 and Instruction	N/A	Marburg Virus Disease Healthcare Worker Monitoring 2024	Attachment A - CDC Marburg Virus Disease Healthcare Worker Monitoring_NonSubChange_10.13.2024.docx	N/A	Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Emergency Response

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 70

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	Previously Approved
Annual Number of Responses for this IC	7,280	7,280
Annual IC Time Burden (Hours)	607	607
Annual IC Cost Burden (Dollars)	0	0

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.