Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
42 CFR 70.11 Report of death or illness onboard aircraft operated by airline Modified 500 58 0 Form and Instruction 0920-26-0140
42 CFR 71.21 - Death/Illness Reports from Aircraft Modified 1400 163 0 Form and Instruction 0920-26-0140
42 CFR 71.33 Report by Persons in Isolation or Surveillance New 11 1 0 Form and Instruction 0920-26-0140
Air Travel Illness or Death Investigation Form New 2500 625 0 Form and Instruction 0920-26-0140
Domestic Airline Manifest Order Template New 500 750 0 Form and Instruction 0920-26-0140
General Contact Investigation Outcome Reporting Form -Air New 60 5 0 Form and Instruction 0920-26-0140
International Airline Manifest Order Template New 350 875 0 Form and Instruction 0920-26-0140
Measles Contact Investigation Outcome Reporting Form – Air New 72 6 0 Form and Instruction 0920-26-0140
Public Health Passenger Locator Form: limited onboard exposure* (domestic flights) New 545 45 0 Form and Instruction 0920-26-0140
Public Health Passenger Locator Form: limited onboard exposure* (international flights) New 545 45 0 Form and Instruction 0920-26-0140
Rubella Contact Investigation Outcome Reporting Form – Air New 1 1 0 Form and Instruction 0920-26-0140
TB Aircraft Contact Investigation Outcome Reporting Form New 51 9 0 Form and Instruction 0920-26-0140
Total burden requested under this ICR: 6535 2583 0  
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