Information Collection

Travelers Requesting Exceptions to Travel Restrictions

IC 282426 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 Travelers Requesting Exceptions to Travel Restrictions	Form and Instruction
2026 Ebola-BVD Response: IPHA Attachment C1 - 2026_EbolaBVD_IPHA.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

0920-26-0272

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				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: 500

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
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	500	500
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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