OMB control number
Emergency Submission for Active Monitoring of Travelers Coming from Ebola-affected Countries and Their Contacts Currently Residing in State, Territorial, and Local Jurisdictions
OMB 0920-1066 ยท HHS/CDC.
OMB 0920-1066
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Weekly Active Monitoring - web | Form |
| Daily Active Monitoring Tracking Report - web | Form |
 Daily Active Monitoring Tracking Report - excel | Form |
| SCTF AM-DAM EmergReq SS_B 20150330clean.docx | Supporting Statement B |
 SCTF AM-DAM EmergReq SS_A 20150519-trackedchanges.doc | Supporting Statement A |
| AttJ - NACCHO OMB Review clean.docx | Supplementary Document |
| AttI - ASTHO OMB Review clean.docx | Supplementary Document |
 AttH - CDC Ebola Assist Memo for State.pdf | Supplementary Document |
| AttB - Interim US Guid Ebola Monit Move.pdf | Supplementary Document |
| AttA - Authorizing Legislation.pdf | Supplementary Document |
 Weekly Active Monitoring - web |
Form |
| Daily Direct Active Monitoring Tracking Report - email |
Instruction |
| Daily Active Monitoring Tracking Report - web |
Form |
| Daily Active Monitoring Tracking Report - excel |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201503-0920-019 | Existing collection in use without an OMB Control Number | 2015-04-01 | Approved with change |