Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Cruise Ship General Outcome Reporting -Maritime (Word & Excel) Unchanged 200 17 0 Form none General Reporting Maritime (Excel)
Form none General Reporting Maritime (Word)
Cruise Ship Measles Outcome Reporting - Maritime (Word & Excel) Unchanged 126 11 0 Form none Measles Maritime (Word)
Form none Measles Maritime (Excel)
Cruise Ship Rubella Outcome Reporting - Maritime (Word & Excel) Unchanged 24 2 0 Form none Rubella Maritime (Word)
Form none Rubella Maritime (Excel)
Cruise Ship TB Outcome Reporting - Maritime (Word & Excel) Unchanged 300 25 0 Form none TB Maritime Word
Form none TB Maritime (Excel)
Ebola Airline Exposure Assessment Airport or other Staff Removed 0 0 0 Form none Ebola Airline Exposure Assessment Airport or Other Staff
Ebola Airline Exposure Assessment Cleaning Staff Removed 0 0 0 Form none Ebola Airline Exposure Assessment Cleaning Staff
Ebola Airline Exposure Assessment Flight Crew Removed 0 0 0 Form none Ebola Airline Exposure Assessment Flight Crew
Ebola Airline Exposure Assessment Passenger Removed 0 0 0 Form none Ebola Airline Exposure Assessment Passenger
Ebola Exposure Questionnaire for Airline Passengers New 340 113 0 Form and Instruction None Ebola Exposure Questionnaire for Airline Passengers
Ebola Exposure Questionnaire for Airport Staff New 100 33 0 Form and Instruction None Ebola Exposure Questionnaire for Airport Staff
Ebola Exposure Questionnaire for Cleaning Crew New 120 40 0 Form and Instruction None Ebola Exposure Questionnaire for Cleaninig Crew
Ebola Exposure Questionnaire for Flight Crew New 240 80 0 Form and Instruction None Ebola Exposure Questionnaire for Flight Crew
Ebola Exposure Questionnaire for Passengers on Other Commercial Conveyances New 180 60 0 Form and Instruction None Ebola Exposure Questionnaire for Passengers of Other Commercial Conveyances
Script for DGMQ HotLine - Introduction New 2500 208 0 Form and Instruction None Script for DGMQ HotLine - Introduction, Flight and Seat Confirmation Ebola Air Contact Investigation
State/Local General Outcome Reporting (Air) Unchanged 12 1 0 Form none General Contact Investigation - Air
State/Local General Outcome Reporting (Land) Unchanged 12 1 0 Form none General Contact Reporting (Land)
State/Local Measles Outcome Reporting (Air) Unchanged 964 80 0 Form none Measles (Air)
State/Local Rubella Outcome Reporting (Air) Unchanged 95 8 0 Form none Rubella (Air)
State/Local TB Outcoming Reporting (Air) Unchanged 1244 104 0 Form none TB Reporting (Air)
Total burden requested under this ICR: 6457 783 0  
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