Information Collection

Cruise Ship Operator - Agreement with Port of Entry with signoff from Local Health Authority

IC 246884 under ICR 202603-0920-015 · OMB 0920-1335.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1335 Attachment M_Agreement with Port of Entry Cruise Ship Operator - Agreement with Port of Entry with signoff from Local Health Authority	Form
ROCIS - Agreement with POE and LHA.docx	Instruction
0920-1335 Attachment M_Agreement with Port of Entry Attachment M_Agreement with Port of Entry.docx	Form

IC Title:

Agency IC Tracking Number:

0920-1335

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Voluntary

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
Instruction					Yes	Yes	Fillable Fileable
Form	0920-1335				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	-30	30
Annual IC Time Burden (Hours)	-300	300
Annual IC Cost Burden (Dollars)	-25,203	25,203

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.

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