OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

[NCEZID] Land Travel-related Public Health Activities

OMB 0920-0134 ยท HHS/CDC.

OMB 0920-0134

The goal of this information collection is to facilitate a CDC public health mission as provided under the Public Health Service Act and Code of Federal Regulations. This Non-Substantive Change Request adds the Air Travel Illness or Death Investigation Form that was previously approved under OMB Control No. 0920-1318 and results in an overall reduction in burden due to a reduction in the number of illness or deaths reported.

The latest form for [NCEZID] Land Travel-related Public Health Activities expires 2026-07-31 and is listed under ICR 202412-0920-009.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 42CFR 71.21(a) Maritime Conveyance illness or Death Investigation FormForm and Instruction
Tuberculosis Land Conveyance Contact Investigation Outcome Reporting FormForm and Instruction
General Land Conveyance Contact Investigation Outcome Reporting FormForm and Instruction
Public Health Land Passenger Locator FormForm and Instruction
Form 0920-0134 Air Travel Illness or Death Investigation FormForm and Instruction
Land Travel Illness or Death Investigation FormForm and Instruction
Form 0920-25CC Maritime Conveyance Illness or Death Investigation Form Section 5Form
Cumulative Influenza/Influenza-Like Illness (ILI) FormForm and Instruction
Attachment B2 - Land Travel-related Public Health Activities_0920-0134_Public Comments_3.18.26.docxPublic Comments
Attachment J - Non-research Determination-0920-0134.pdfSupplementary Document
Attachment I - QARS-PHARS_PIA.pdfSupplementary Document
Attachment B1- 60 Day Federal Register Notice 2026-00422.pdfSupplementary Document
Attachment A3 42 CFR part 70.pdfSupplementary Document
Attachment A2 42 CFR part 71.pdfSupplementary Document
Attachment A1 Section 361 of the Public Health Service Act (42 USC 264).pdfSupplementary Document
SSA 0920-0134_Land Travel-related Activities_3.10.26-Final_final.docxSupporting Statement A
SSB_0920-0134_Land Travel-related Activites_3.10.26-Final.docx (document unavailable)Supporting Statement B
Att H_42CFR71.21(a )_ Maritime Conveyance Illness or Death Investigation Form (Sections 1-4) Form and Instruction
Att H_42CFR71.21(a )_ Maritime Conveyance Illness or Death Investigation Form (Sections 1-4) Form and Instruction
Report by the Master of a Vessel or Person in Charge of Conveyance of the Incidence of a Communicable Disease Occurring While in Interstate Travel Other-OMB Header and Burden Statement
TB Land Contact Investigation Outcome Reporting Form Form and Instruction
TB Land Contact Investigation Outcome Reporting Form Form and Instruction
General Land Contact Investigation Outcome Reporting Form Form and Instruction
General Land Contact Investigation Outcome Reporting Form Form and Instruction
Domestic Land Conveyance Manifest Order Template Instruction
International Land Conveyance Manifest Order Template Instruction
Land Passenger Locator Form Form and Instruction
Land Passenger Locator Form Form and Instruction
Air Travel Illness or Death Investigation Form Form and Instruction
Air Travel Illness or Death Investigation Form Form and Instruction
Land Travel Illness or Death Investigation Form Form and Instruction
Land Travel Illness or Death Investigation Form Form and Instruction
Maritime Conveyance Illness or Death Investigation Form (Section 5) Form
Maritime Conveyance Illness or Death Investigation Form (Section 5) Form
Cumulative Influenza/Influenza-Like Illness (ILI) Form Form and Instruction
Cumulative Influenza/Influenza-Like Illness (ILI) Form Form and Instruction
Att I_42CFR71.21(b)_Death/Illness Reports from Aircraft Information collection
42CFR71.35_Report of Dealth Illness During Stay in Port ((verbal, no form)) Information collection
42CFR71.33(c) Report by Persons in Isolation or Surveillance ((no form)) Information collection

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202603-0920-008 Revision of a currently approved collection 2026-03-19
202412-0920-009 No material or nonsubstantive change to a currently approved collection 2024-12-17 Approved without change
202305-0920-006 No material or nonsubstantive change to a currently approved collection 2023-05-12 Approved without change
202203-0920-014 Revision of a currently approved collection 2022-03-31 Approved without change
202111-0920-018 No material or nonsubstantive change to a currently approved collection 2021-11-18 Approved without change
202111-0920-006 No material or nonsubstantive change to a currently approved collection 2021-11-03 Approved without change
202107-0920-009 No material or nonsubstantive change to a currently approved collection 2021-07-23 Approved without change
202009-0920-024 No material or nonsubstantive change to a currently approved collection 2020-10-05 Approved without change
202007-0920-016 No material or nonsubstantive change to a currently approved collection 2020-07-24 Approved without change
202004-0920-008 No material or nonsubstantive change to a currently approved collection 2020-04-14 Approved without change
202004-0920-003 No material or nonsubstantive change to a currently approved collection 2020-04-07 Approved with change
201904-0920-008 No material or nonsubstantive change to a currently approved collection 2019-04-26 Approved without change
201811-0920-003 Revision of a currently approved collection 2018-11-27 Approved with change
201611-0920-006 No material or nonsubstantive change to a currently approved collection 2016-11-16 Approved without change
201608-0920-009 No material or nonsubstantive change to a currently approved collection 2016-08-16 Approved without change
201509-0920-005 Revision of a currently approved collection 2015-11-17 Approved with change
201502-0920-010 No material or nonsubstantive change to a currently approved collection 2015-02-18 Approved without change
201406-0920-014 Revision of a currently approved collection 2014-07-02 Approved with change
201305-0920-003 No material or nonsubstantive change to a currently approved collection 2013-05-08 Approved without change
201304-0920-018 No material or nonsubstantive change to a currently approved collection 2013-04-29 Approved with change
201304-0920-012 No material or nonsubstantive change to a currently approved collection 2013-04-19 Improperly submitted and continue
201208-0920-001 No material or nonsubstantive change to a currently approved collection 2012-08-02 Approved without change
201207-0920-011 No material or nonsubstantive change to a currently approved collection 2012-07-27 Approved without change
201204-0920-005 Revision of a currently approved collection 2012-04-25 Approved with change
201110-0920-002 No material or nonsubstantive change to a currently approved collection 2011-10-04 Approved without change
200906-0920-019 Extension without change of a currently approved collection 2009-06-24 Approved without change
200509-0920-010 Revision of a currently approved collection 2005-09-23 Approved with change
200110-0920-007 No material or nonsubstantive change to a currently approved collection 2001-10-22 Approved without change
200107-0920-003 Extension without change of a currently approved collection 2001-07-23 Approved without change
199803-0920-003 Reinstatement with change of a previously approved collection 1998-03-26 Approved without change
199405-0920-002 Revision of a currently approved collection 1994-05-20 Approved without change
199105-0920-001 Reinstatement with change of a previously approved collection 1991-05-13 Approved without change
199102-0920-006 No material or nonsubstantive change to a currently approved collection 1991-02-04 Approved with change
198903-0920-002 Extension without change of a currently approved collection 1989-03-09 Approved without change
198812-0920-001 Reinstatement with change of a previously approved collection 1988-12-07 Approved without change
198604-0920-003 No material or nonsubstantive change to a currently approved collection 1986-04-07 Approved with change
198509-0920-002 Revision of a currently approved collection 1985-09-30 Approved without change
198501-0920-002 No material or nonsubstantive change to a currently approved collection 1985-01-25 Approved with change
198308-0920-003 New collection (Request for a new OMB Control Number) 1983-08-10 Approved without change

OMB Details

Att H_42CFR71.21(a )_ Maritime Conveyance Illness or Death Investigation Form (Sections 1-4)

Federal Enterprise Architecture: Health - Immunization Management

Information collection instruments
FormNameElectronic accessType
Form 42CFR 71.21(a)Maritime Conveyance illness or Death Investigation FormNAForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.