Information Collection List

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