Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
42 CFR 70.3 Applicant Traveler Modified 2000 500 0 Form none
42 CFR 70.3 Copy of Materials -Attending Physician Modified 2000 500 0 Form none
42 CFR 70.3 Permit Issued by State Health Authority Modified 2000 200 0 Form none
42 CFR 70.4 Copy of Material submitted to Health Authority New 200 50 0 Form none
42 CFR 70.4 Copy of Materials -State or Local Health Authority Modified 1500 150 0 Form none
42 CFR 70.4 Report by Master of Vessel or Person in Charge of Conveyance Modified 1500 375 0 Form none
42 CFR 70.4 Report of communicable disease while in interstate travel by Master of Vessel New 200 50 0 Form none
42 CFR 70.5 Application to Move from State to State in the Communicable Period (Attending Physician) Modified 3750 938 0 Form none
42 CFR 70.5 Application to Move from State to State in the Communicable Period (Traveler) Modified 3750 938 0 Form none
Total burden requested under this ICR: 16900 3701 0  
To view an IC, click on IC Title