OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

[NCZEID] Report of Illness or Death: Interstate Travel of Persons (42 CFR part 70)

OMB 0920-0488 · HHS/CDC.

OMB 0920-0488

The goal of this information collection is to ensure that CDC can collect data related to communicable diseases or deaths that occur aboard conveyances during interstate travel within the United States. Data is used by CDC to assess and respond to reports of communicable disease or death that occur on conveyances engaged in interstate travel, and assist state and local health authorities if an illness or death occurs that poses a risk to public health. As required by regulation, all instances of communicable disease characterized by certain signs and symptoms must be reported to the local health authority with jurisdiction over the arrival port. CDC has accepted reports to CDC as fulfilling this requirement. CDC also requests reports of all deaths occurring during domestic flights.In this Revision, CDC is requesting approval for an additional three years. The total burden hours from the last revision has increased from 23 to 186 hours. This is due to more reports coming in related to the COVID-19 pandemic.

The latest form for [NCZEID] Report of Illness or Death: Interstate Travel of Persons (42 CFR part 70) expires 2026-07-31 and is listed under ICR 202206-0920-013.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0920-26-0140 TB Aircraft Contact Investigation Outcome Reporting FormForm and Instruction
Form 0920-26-0140 Rubella Contact Investigation Outcome Reporting Form – AirForm and Instruction
Form 0920-26-0140 Measles Aircraft Contact Investigation Outcome Reporting FormForm and Instruction
Form 0920-26-0140 General Aircraft Contact Investigation Outcome Reporting FormForm and Instruction
Form 0920-26-0140 Domestic Manifest Order TemplateForm and Instruction
Form 0920-26-0140 International Airline Manifest Order TemplateForm and Instruction
Form 0920-26-0140 Passenger Locator Form - DOMESTICForm and Instruction
Form 0920-26-0140 Passenger Locator Form - INTERNATIONALForm and Instruction
Form 0920-26-0140 Air Travel Illness or Death Investigation FormForm and Instruction
Form 0920-26-0140 42 CFR 71.33 Report by Persons in Isolation or SurveillanceForm and Instruction
Form 0920-26-0140 42 CFR 70.11 - Report of death or illness onboard aircraft operated by airlineForm and Instruction
Form 0920-26-0140 42 CFR 70.4 - Report by the master of a vessel or person in charge of conveyance of the incidence of a communicable disease occurring while in interstate travelForm and Instruction
Attachment K - CDC FAA Memorandum of Agreement.pdfSupplementary Document
Attachment M - Non-researchDetermination_0920-0488.pdfSupplementary Document
Attachment B2 - 60-day FRN 0920-0488 Public Comment.docx (document unavailable)Public Comments
Attachment B2 - 60-day FRN 0920-0488 Public Comments-3.19.26.docxPublic Comments
Attachment A3 42 CFR 70.pdfSupplementary Document
Attachment A2 42 CFR 71.pdfSupplementary Document
Attachment A1 Section 361 of the Public Health Service Act (42 USC 264).pdfSupplementary Document
0920-0488 _30_Day_FRN_Notice_Clean.docx (document unavailable)Supplementary Document
Attachment F 0920-0488 CDC Non-research determination.pdfSupplementary Document
Attachment E Privacy Impact Assessment.pdfSupplementary Document
Attachment D CDC FAA Memorandum of Agreement.pdfSupplementary Document
Attachment C Public Comment-0920-0488-Final.docxSupplementary Document
Attachment B 60-Day FRN-4.1.2022.pdf (document unavailable)Supplementary Document
SSB_0920-0488Aviation-RelatedPublicHealthActivities_30d_Final.docx (document unavailable)Supporting Statement B
SSA_0920-0488.docxSupporting Statement A
TB Aircraft Contact Investigation Outcome Reporting Form Form and Instruction
TB Aircraft Contact Investigation Outcome Reporting Form Form and Instruction
Rubella Contact Investigation Outcome Reporting Form – Air Form and Instruction
Rubella Contact Investigation Outcome Reporting Form – Air Form and Instruction
Measles Contact Investigation Outcome Reporting Form – Air Form and Instruction
Measles Contact Investigation Outcome Reporting Form – Air Form and Instruction
General Contact Investigation Outcome Reporting Form -Air Form and Instruction
General Contact Investigation Outcome Reporting Form -Air Form and Instruction
Domestic Airline Manifest Order Template Form and Instruction
Domestic Airline Manifest Order Template Form and Instruction
International Airline Manifest Order Template Form and Instruction
International Airline Manifest Order Template Form and Instruction
Public Health Passenger Locator Form: limited onboard exposure* (domestic flights) Form and Instruction
Public Health Passenger Locator Form: limited onboard exposure* (domestic flights) Form and Instruction
Public Health Passenger Locator Form: limited onboard exposure* (international flights) Form and Instruction
Public Health Passenger Locator Form: limited onboard exposure* (international flights) Form and Instruction
Air Travel Illness or Death Investigation Form Form and Instruction
Air Travel Illness or Death Investigation Form Form and Instruction
42 CFR 71.33 Report by Persons in Isolation or Surveillance Form and Instruction
42 CFR 71.33 Report by Persons in Isolation or Surveillance Form and Instruction
42 CFR 70.11 Report of death or illness onboard aircraft operated by airline Form and Instruction
42 CFR 70.11 Report of death or illness onboard aircraft operated by airline Form and Instruction
42 CFR 71.21 - Death/Illness Reports from Aircraft Form and Instruction
42 CFR 71.21 - Death/Illness Reports from Aircraft Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202603-0920-009 Revision of a currently approved collection 2026-03-23
202206-0920-013 Revision of a currently approved collection 2022-06-29 Approved without change
201810-0920-002 Revision of a currently approved collection 2018-11-15 Approved with change
201512-0920-001 Revision of a currently approved collection 2015-12-10 Approved with change
201302-0920-007 Revision of a currently approved collection 2013-02-08 Approved with change
201301-0920-007 Revision of a currently approved collection 2013-01-24 Improperly submitted and continue
201002-0920-009 Extension without change of a currently approved collection 2010-02-24 Approved without change
200807-0920-002 Reinstatement without change of a previously approved collection 2008-07-11 Approved with change
200311-0920-001 Reinstatement without change of a previously approved collection 2003-11-07 Approved without change
200007-0920-003 New collection (Request for a new OMB Control Number) 2000-07-25 Approved without change

OMB Details

42 CFR 70.4 - 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

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
FormNameElectronic accessType
Form 0920-048842 CFR 70.4 - Report by the master of a vessel or person in charge of conveyance of the incidence of a communicable disease occurring while in interstate travelNAForm and instruction

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