Information Collection

CDC Initial Screening – Marburg

IC 271515 under ICR 202411-0920-008 · OMB 0920-1443.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1443 CDC Initial Screening – Marburg	Form and Instruction
0920-1443 CDC Initial Screening at POE (CDC Primary) – Marburg Res Attachment C- CDC Initial Screening Form_Marburg 16OCT2024.docx	Form and Instruction
0920-1443 CDC Initial Screening at POE (CDC Primary) – Marburg Res Attachment C- CDC Initial Screening Form_Marburg 16OCT2024.docx	Form and Instruction
0920-1443 CDC Initial Screening Form_Marburg_ Attachment A - CDC Initial Screening Form_Marburg_Clean_11.12.2024.docx	Form and Instruction
0920-1443 CDC Initial Screening Form_Marburg_ Attachment A - CDC Initial Screening Form_Marburg_Clean_11.12.2024.docx	Form and Instruction

IC Title:

CDC Initial Screening â Marburg

Agency IC Tracking Number:

0920-25AE

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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	0920-1443	CDC Initial Screening at POE (CDC Primary) â Marburg Response 16OCT2024	Attachment C- CDC Initial Screening Form_Marburg 16OCT2024.docx	N/A	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1443	CDC Initial Screening Form_Marburg_	Attachment A - CDC Initial Screening Form_Marburg_Clean_11.12.2024.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

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

FR Citation: 83 FR 6591

Number of Respondents: 43,800

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	43,800	43,800
Annual IC Time Burden (Hours)	3,650	3,650
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.