Information Collection

2026 Ebola Symptom Monitoring Web Survey

IC 280538 under ICR 202605-0920-004 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Ebola Web Survey for Symptomatic Travelers 2026 Ebola Symptom Monitoring Web Survey	Form and Instruction
Ebola Web Survey for Symptomatic Travelers Attachment E3 - 2026 Ebola Symptom Monitoring Web Survey.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	N/A			N/A	Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Emergency Response

Privacy Act System of Records

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

FR Citation: 72 FR 70867

Number of Respondents: 365

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	7,665	7,665
Annual IC Time Burden (Hours)	639	639
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.

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