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 2026-06-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920-26-0140 TB Aircraft Contact Investigation Outcome Reporting Form Form and Instruction
Form 0920-26-0140 Rubella Contact Investigation Outcome Reporting Form – Air Form and Instruction
Form 0920-26-0140 Measles Aircraft Contact Investigation Outcome Reporting Form Form and Instruction
Form 0920-26-0140 General Aircraft Contact Investigation Outcome Reporting Form Form and Instruction
Form 0920-26-0140 Domestic Manifest Order Template Form and Instruction
Form 0920-26-0140 International Airline Manifest Order Template Form and Instruction
Form 0920-26-0140 Passenger Locator Form - DOMESTIC Form and Instruction
Form 0920-26-0140 Passenger Locator Form - INTERNATIONAL Form and Instruction
Form 0920-26-0140 Air Travel Illness or Death Investigation Form Form and Instruction
Form 0920-26-0140 42 CFR 71.33 Report by Persons in Isolation or Surveillance Form and Instruction
Form 0920-26-0140 42 CFR 70.11 - Report of death or illness onboard aircraft operated by airline Form 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 travel Form and Instruction
Attachment K - CDC FAA Memorandum of Agreement.pdf Supplementary Document
Attachment M - Non-researchDetermination_0920-0488.pdf (document unavailable) Supplementary 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.docx (document unavailable) Public Comments
Attachment A3 42 CFR 70.pdf (document unavailable) Supplementary Document
Attachment A2 42 CFR 71.pdf Supplementary Document
Attachment A1 Section 361 of the Public Health Service Act (42 USC 264).pdf Supplementary Document
0920-0488 _30_Day_FRN_Notice_Clean.docx (document unavailable) Supplementary Document
Attachment F 0920-0488 CDC Non-research determination.pdf (document unavailable) Supplementary Document
Attachment E Privacy Impact Assessment.pdf Supplementary Document
Attachment D CDC FAA Memorandum of Agreement.pdf (document unavailable) Supplementary Document
Attachment C Public Comment-0920-0488-Final.docx (document unavailable) Supplementary 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.docx (document unavailable) Supporting 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

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

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

Form 0920-0488

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

Form and instruction

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