Information Collection

Initial PHA _2026 Ebola DRC

IC 280528 under ICR 202609-0920-004 · OMB 0920-1469.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2026 Ebola-BVD Response: IPHA Initial PHA _2026 Ebola DRC	Form and Instruction
Pre-Arrival Public Health Assessment for Travelors from Ebola-affected Countries Initial PHA _2026 Ebola DRC	Form and Instruction
2026 Ebola-BVD Response: IPHA Attachment C1 - 2026_EbolaBVD_IPHA.docx	Form and Instruction
Pre-Arrival Public Health Assessment for Travelors from Attachment C2 - 2026 EbolaBVD_IPHA_Traveler_final.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

0920-26-0272

Is this a Common Form? No

IC Status: Modified

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
Form and Instruction	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: 54,750

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	54,750	18,250	36,500
Annual IC Time Burden (Hours)	9,125	6,083	3,042
Annual IC Cost Burden (Dollars)	0	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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