PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
COVID-2019 Air Traveler Illness and Death Investigation Form
New
10000
2500
0
Form and Instruction
0920-20HF
Air Traveler Illness or Death Investigation Form
COVID-2019 Referral Slip
New
300000
25000
0
Form and Instruction
0920-20HF
Referral Slip
Daily Sympton Check
New
280000
23333
0
Other-Recorded
Preboarding Health Screen
New
20000
1667
0
Form and Instruction
0920-20HF
Preboarding Health Screen
Supplemental 2019 Questionnaire
New
25000
4167
0
Form and Instruction
0920-20HF
Supplemental Questionnaire
United States Travel Health Declaration for Repatriation
New
10000
2500
0
Form and Instruction
0920-20HF
US Traveler Health Declaration for Repatriation
United States Travel Health Declaration for Repatriation from Ship
New
10000
2500
0
Form and Instruction
0920-20HF
US Traveler Health Declaration Repatriation from Ship
United States Traveler Health Declaration
New
300000
75000
0
Form and Instruction
0920-20HF
US Traveler health Declaration Web
Form and Instruction
0920-20HF
US Traveler Health Declaration Fillable PDF
Form and Instruction
0920-20HF
US Traveler Health Declaration Paper
Total burden requested under this ICR:
955000
136667
0
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