Information Collection

2024 Marburg Symptom Monitoring - Daily Group_Web Survey for Symptomatic Travelers

IC 272458 under ICR 202411-0920-012 · OMB 0920-1451.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-XXXX 2024 Marburg Symptom Monitoring - Daily Group_Web Survey for Symptomatic Travelers	Form and Instruction
0920-XXXX 2024 Marburg Symptom Monitoring - Daily Group Web Survey Attachment C3 - 2024 Marburg Symptom Monitoring Web Survey.docx	Form and Instruction
0920-XXXX 2024 Marburg Symptom Monitoring - Daily Group Web Survey Attachment C3a - 2024 Marburg Symptom Monitoring Web Survey_Kinyarwanda.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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-XXXX	2024 Marburg Symptom Monitoring - Daily Group Web Survey_Engish	Attachment C3 - 2024 Marburg Symptom Monitoring Web Survey.docx	N/A	Yes	Yes	Fillable Fileable
Form and Instruction	0920-XXXX	2024 Marburg Symptom Monitoring - Daily Group Web Survey_Kinyarwanda	Attachment C3a - 2024 Marburg Symptom Monitoring Web Survey_Kinyarwanda.docx	N/A	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title: 09-20-0171, Quarantine- and Traveler-Related Activities, including Records for Contact Tracing Investigation and Notification

FR Citation: 83 FR 6591

Number of Respondents: 438

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	9,198	9,198
Annual IC Time Burden (Hours)	767	767
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.