Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
COVID-19 Program for Cruise Ships Notice of Participation/Nonparticipation Removed 0 0 0 Form 0920-1335
Cruise Ship Brand/Operator - Agreement with Health Care Organization with signoff from Local Health Authorities Removed 0 0 0 Instruction
Form 0920-1335
Cruise Ship Brand/Operator - Agreement with Housing Facility with signoff from Local Health Authorities Removed 0 0 0 Instruction
Form 0920-1335
Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form (submitted once per voyage, within 24 hours before arrival in U.S.) Modified 4000 667 0 Form and Instruction n/a
Cruise Ship Cumulative Acute Respiratory Illness (submitted sooner than 24 hours before arrival in U.S because 3% or more of the voyage's passengers or crew have ARI) Modified 300 50 0 Form and Instruction n/a
Cruise Ship Holding Company - COVID-19 Response Plan Removed 0 0 0 Instruction
Cruise Ship Operator - Agreement with Port of Entry with signoff from Local Health Authority Removed 0 0 0 Instruction
Form 0920-1335
Cruise Ship Operator - Remote and In-person Inspections Removed 0 0 0 Instruction
Instruction
Cruise Ship Physician - COVID-19 Case Investigation Worksheet (if necessary) Removed 0 0 0 Form 0920-1335
Form 0920-1335
Cruise Ship Physician - COVID-19 Contact Investigation Worksheet (if necessary) Removed 0 0 0 Form 0920-1335
Cruise Ship Vaccination Status Classification Removed 0 0 0 Form 0920-1335
General Maritime Contact Investigation Outcome Reporting Form New 15 8 0 Form and Instruction n/a
Maritime Conveyance Illness or Death Investigation Form [Section 5] New 100 8 0 Form and Instruction n/a
Maritime Conveyance Illness or Death Investigation Form [Sections 1-4] New 500 83 0 Form and Instruction n/a
Report of Death Illness During Stay in Port (Verbal-No Form) New 5 3 0 Other-OMB Header and Burden Statement
Report of Death Illness from Ship (Verbal-No Form) New 50 6 0 Other-OMB Header and Burden Statement
TB Maritime Contact Investigation Worksheet New 3 2 0 Form n/a
Varicella Outbreak Enhanced Data Collection Form - Maritime New 18 9 0 Form and Instruction n/a
Total burden requested under this ICR: 4991 836 0  
To view an IC, click on IC Title