Information Collection

POE Public Health Risk Assessment Form - CDC Marburg Response

IC 271517 under ICR 202411-0920-008 · OMB 0920-1443.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
POE Public Health Risk Assessment Form - CDC Marburg Response	Form and Instruction
CDC RISK ASSESSMENT AT POE (CDC Secondary) – Marburg Res Attachment D - POE Public Health Risk Assessment Form_CDC Marburg Response_10 08 2024.docx	Form and Instruction
CDC RISK ASSESSMENT AT POE (CDC Secondary) – Marburg Res Attachment D - POE Public Health Risk Assessment Form_CDC Marburg Response_10 08 2024.docx	Form and Instruction
0920-1443 CDC RISK ASSESSMENT AT POE (CDC Secondary) – Marburg Res Attachment D- POE Public Health Risk Assessment Form_Marburg 16OCT2024.docx.docx	Form and Instruction
0920-1443 CDC RISK ASSESSMENT AT POE (CDC Secondary) – Marburg Res Attachment D- POE Public Health Risk Assessment Form_Marburg 16OCT2024.docx.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

0920-25AE

Is this a Common Form? No

IC Status: Unchanged

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	n/a	CDC RISK ASSESSMENT AT POE (CDC Secondary) â Marburg Response	Attachment D - POE Public Health Risk Assessment Form_CDC Marburg Response_10 08 2024.docx		Yes	Yes	Fillable Fileable
Form and Instruction	0920-1443	CDC RISK ASSESSMENT AT POE (CDC Secondary) â Marburg Response	Attachment D- POE Public Health Risk Assessment Form_Marburg 16OCT2024.docx.docx	N/A	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: 4,380

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	4,380	4,380
Annual IC Time Burden (Hours)	1,460	1,460
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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