[NCEZID] Maritime-related Public Health Activities

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
General Maritime Contact Investigation Outcome Reporting Worksheet	Form and Instruction	New	Available
Varicella Outbreak Reporting Form	Form and Instruction	New	Available
TB Maritime Investigation Worksheet	Form	New	Available
Maritime Conveyance Illness or Death Investigation Form	Form and Instruction	New	Available
Maritime Conveyance Illness or Death Investigation Form	Form and Instruction	New	Available
Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form	Form and Instruction	Modified	Available
Form 0920-1335 Attachment E_Notice of Participation-Nonparticipation	Form	Removed	Available
Form 0920-1335 Attachment F_Cruise Ship Vaccination Status Classification	Form	Removed	Available
Form 0920-1335 Attachment L_Cruise COVID19 Contact Investigation Worksheet	Form	Removed	Available
Form 0920-1335 Attachment K_Cruise COVID19 Case Investigation Worksheet	Form	Removed	Available
Form 0920-1335 COVID-19 Case Investigation worksheet	Form	Removed	Available
Form 0920-1335 Attachment O_Agreement with Housing Facility	Form	Removed	Available
Form 0920-1335 Attachment M_Agreement with Port of Entry	Form	Removed	Available
Form 0920-1335 Attachment N_Agreement with Health Care Organization	Form	Removed	Available
Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form	Form and Instruction	Modified	Available
Attachment B2 - 60-day FRN 0920-1335 Notice Public Comment.docx	Public Comments	Uploaded 2026-03-05	Available
Attachment I - 0920-1335_NonResearchDetermination_Signed-3.9.2026.pdf	Supplementary Document	Uploaded 2026-03-31	Available
Attachment H - QARS_PIA.pdf	Supplementary Document	Uploaded 2026-03-31	Available
Attachment B1 - 60-day FRN 0920-1335 Notice (Jan. 15, 2026).pdf	Supplementary Document	Uploaded 2026-03-31	Available
SSB_0920-1335Maritime-relatedPublicHealthActivities_30d_final.docx	Supporting Statement B	Uploaded 2026-03-31	Available
Attachment A2 42 CFR 71.pdf	Supplementary Document	Uploaded 2026-03-31	Available
Attachment A3 42 CFR 70.pdf	Supplementary Document	Uploaded 2026-03-31	Available
Attachment A1 Section 361 of the Public Health Service Act (42 USC 264).pdf	Supplementary Document	Uploaded 2026-03-31	Available
SSA_0920-1335Maritime-relatedPublicHealthActivities_30d_final_final.docx	Supporting Statement A	Uploaded 2026-03-31	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
279768	General Maritime Contact Investigation Outcome Reporting Form	Form and Instruction	New	General Maritime Contact Investigation Outcome Reporting Worksheet
279767	Varicella Outbreak Enhanced Data Collection Form - Maritime	Form and Instruction	New	Varicella Outbreak Reporting Form
279766	TB Maritime Contact Investigation Worksheet	Form	New	TB Maritime Investigation Worksheet
279763	Maritime Conveyance Illness or Death Investigation Form [Section 5]	Form and Instruction	New	Maritime Conveyance Illness or Death Investigation Form
279762	Maritime Conveyance Illness or Death Investigation Form [Sections 1-4]	Form and Instruction	New	Maritime Conveyance Illness or Death Investigation Form
279761	Report of Death Illness During Stay in Port (Verbal-No Form)	Other-OMB Header and Burden Statement	New
279760	Report of Death Illness from Ship (Verbal-No Form)	Other-OMB Header and Burden Statement	New
263080	Cruise Ship Cumulative Acute Respiratory Illness (submitted sooner than 24 hours before arrival in U.S because 3% or more of the voyage's passengers or crew have ARI)	Form and Instruction	Modified	Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form
252174	COVID-19 Program for Cruise Ships Notice of Participation/Nonparticipation	Form	Removed	Attachment E_Notice of Participation-Nonparticipation
252173	Cruise Ship Vaccination Status Classification	Form	Removed	Attachment F_Cruise Ship Vaccination Status Classification
248858	Cruise Ship Physician - COVID-19 Contact Investigation Worksheet (if necessary)	Form	Removed	Attachment L_Cruise COVID19 Contact Investigation Worksheet
248855	Cruise Ship Physician - COVID-19 Case Investigation Worksheet (if necessary)	Form	Removed	Attachment K_Cruise COVID19 Case Investigation Worksheet
248855	Cruise Ship Physician - COVID-19 Case Investigation Worksheet (if necessary)	Form	Removed	COVID-19 Case Investigation worksheet
246889	Cruise Ship Operator - Remote and In-person Inspections	Instruction	Removed
246885	Cruise Ship Brand/Operator - Agreement with Housing Facility with signoff from Local Health Authorities	Form	Removed	Attachment O_Agreement with Housing Facility
246885	Cruise Ship Brand/Operator - Agreement with Housing Facility with signoff from Local Health Authorities	Instruction	Removed
246884	Cruise Ship Operator - Agreement with Port of Entry with signoff from Local Health Authority	Form	Removed	Attachment M_Agreement with Port of Entry
246884	Cruise Ship Operator - Agreement with Port of Entry with signoff from Local Health Authority	Instruction	Removed
246883	Cruise Ship Brand/Operator - Agreement with Health Care Organization with signoff from Local Health Authorities	Form	Removed	Attachment N_Agreement with Health Care Organization
246883	Cruise Ship Brand/Operator - Agreement with Health Care Organization with signoff from Local Health Authorities	Instruction	Removed
246878	Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form (submitted once per voyage, within 24 hours before arrival in U.S.)	Form and Instruction	Modified	Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form
246872	Cruise Ship Holding Company - COVID-19 Response Plan	Instruction	Removed

ICR Details

OMB Control No: 0920-1335	ICR Reference No: 202603-0920-015
Status: Received in OIRA	Previous ICR Reference No: 202310-0920-011
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-26-0163
Title: [NCEZID] Maritime-related Public Health Activities
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 04/14/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	4,991	0
Time Burden (Hours)	836	0
Cost Burden (Dollars)	0	0

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Abstract: The purpose of this activity is to collect data related to maritime travelers involved with exposure or contraction of disease when traveling. Respondents include operators of all commercial passenger-carrying vessels, cargo ships, international ferries, fishing boats, and research vessels that seek to operate in international waterways and subject to the jurisdiction of the United States. Some data are required such as reports of ill persons (defined in 42 CFR Part 71.1) and deaths (42 CFR Part 71.21, 70.4, and 70.35). Other information collections help CDC understand risk and facilitate assistance to ships. This is a Reinstatement with Change that includes removal and addition of instruments and a burden decrease.

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Authorizing Statute(s): US Code: 42 USC CFR 71 Name of Law: Foreign Quarantine
   US Code: 42 USC 264 Name of Law: PHSA
   US Code: 42 USC CFR 70 Name of Law: Interstate Quarantine
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 1794	01/15/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 19137	04/14/2026
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 9

table that charts list of burden

IC Title	Form No.	Form Name
COVID-19 Program for Cruise Ships Notice of Participation/Nonparticipation	0920-1335	Attachment E_Notice of Participation-Nonparticipation
Cruise Ship Brand/Operator - Agreement with Health Care Organization with signoff from Local Health Authorities	0920-1335	Attachment N_Agreement with Health Care Organization
Cruise Ship Brand/Operator - Agreement with Housing Facility with signoff from Local Health Authorities	0920-1335	Attachment O_Agreement with Housing Facility
Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form (submitted once per voyage, within 24 hours before arrival in U.S.)	n/a	Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form
Cruise Ship Cumulative Acute Respiratory Illness (submitted sooner than 24 hours before arrival in U.S because 3% or more of the voyage's passengers or crew have ARI)	n/a	Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form
Cruise Ship Holding Company - COVID-19 Response Plan
Cruise Ship Operator - Agreement with Port of Entry with signoff from Local Health Authority	0920-1335	Attachment M_Agreement with Port of Entry
Cruise Ship Operator - Remote and In-person Inspections
Cruise Ship Physician - COVID-19 Case Investigation Worksheet (if necessary)	0920-1335, 0920-1335	COVID-19 Case Investigation worksheet ,   Attachment K_Cruise COVID19 Case Investigation Worksheet
Cruise Ship Physician - COVID-19 Contact Investigation Worksheet (if necessary)	0920-1335	Attachment L_Cruise COVID19 Contact Investigation Worksheet
Cruise Ship Vaccination Status Classification	0920-1335	Attachment F_Cruise Ship Vaccination Status Classification
General Maritime Contact Investigation Outcome Reporting Form	n/a	General Maritime Contact Investigation Outcome Reporting Worksheet
Maritime Conveyance Illness or Death Investigation Form [Section 5]	n/a	Maritime Conveyance Illness or Death Investigation Form
Maritime Conveyance Illness or Death Investigation Form [Sections 1-4]	n/a	Maritime Conveyance Illness or Death Investigation Form
Report of Death Illness During Stay in Port (Verbal-No Form)
Report of Death Illness from Ship (Verbal-No Form)
TB Maritime Contact Investigation Worksheet	n/a	TB Maritime Investigation Worksheet
Varicella Outbreak Enhanced Data Collection Form - Maritime	n/a	Varicella Outbreak Reporting Form

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ICR Summary of Burden

table that charts list of burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	4,991	0	0	4,490	0	501
Annual Time Burden (Hours)	836	0	0	-879	0	1,715
Annual Cost Burden (Dollars)	0	0	0	-107,556	0	107,556

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Changing Forms

Short Statement: The reduction in burden is due to addition/removal of instruments and adjustment to respondent numbers.

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Annual Cost to Federal Government: $211,616

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Yes

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/14/2026

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