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 Unchanged 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 Unchanged 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) Modified 100 8 0 Form 0920-25CC Maritime Conveyance Illness or Death Investigation Form Section 5
Total burden requested under this ICR: 14616 2078 21910  
To view an IC, click on IC Title