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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
42CFR71.33(c) Report by Persons in Isolation or Surveillance ((no form))
Unchanged
11
1
24
42CFR71.35_Report of Dealth Illness During Stay in Port ((verbal, no form))
Unchanged
5
3
117
Air Travel Illness or Death Investigation Form
New
4000
1000
0
Form and Instruction
0920-0134
Air Travel Illness or Death Investigation Form
Att H_42CFR71.21(a )_ Maritime Conveyance Illness or Death Investigation Form (Sections 1-4)
Unchanged
500
83
1635
Form and Instruction
42CFR 71.21(a)
Maritime Conveyance illness or Death Investigation Form
Att I_42CFR71.21(b)_Death/Illness Reports from Aircraft
Modified
4000
133
10399
Cumulative Influenza/Influenza-Like Illness (ILI) Form
Unchanged
3000
100
3893
Form and Instruction
none
Cumulative Influenza/Influenza-Like Illness (ILI) Form
Land Travel Illness or Death Investigation Form
Unchanged
3000
750
5842
Form
none
Land Travel Illness or Death Investigation Form
Maritime Conveyance Illness or Death Investigation Form (Section 5)
Unchanged
100
8
117
Form and Instruction
42 CFR 71.21(a)
Maritime Conveyance Illness or Death Investigation Form (Section 5)
Total burden requested under this ICR:
14616
2078
22027
To view an IC, click on IC Title