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Att H_42CFR71.21(a )_ Maritime Conveyance Illness or Death Investigation Form (Sections 1-4)

IC 6646 under ICR 202603-0920-008 · OMB 0920-0134.

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Att H_42CFR71.21(a )_ Maritime Conveyance Illness or Death Investigation Form (Sections 1-4)
 
No Removed
 
Mandatory
 
42 CFR Subpart C  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 42CFR 71.21(a) Maritime Conveyance illness or Death Investigation Form Attachment D - Maritime Conveyance Illness or Death Investigation Form.pdf NA Yes Yes Fillable Fileable

Health Immunization Management

Quarantine and Traveler-Related Activities, Including Records for Tracing, Investigation and Notification under 42 CFR Parts 70 and 71  72 FR 70867

500 0
   
Private Sector Businesses or other for-profits
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 0 0 -500 0 0 500
Annual IC Time Burden (Hours) 0 0 -83 0 0 83
Annual IC Cost Burden (Dollars) 0 0 -1,635 0 0 1,635

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