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Attestation of a negative COVID-19 test/Documentation indicating clearance for travel by a licensed healthcare provider or public health official - Traveler
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA PASSENGER DISCLOSURE AND ATTESTATION Attachment D1 - GLOBAL - Passenger disclosure and attestation Attachment A to Order.pdf NA Yes Yes Fillable Fileable

Health Illness Prevention

09-20-0171 - Quarantine-and-Traveler-Related Activities, Including Records for Contact Tracing   83 FR 6591

95,000,000 0
   
Individuals or Households
 
   50 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 95,000,000 0 61,000,000 0 0 34,000,000
Annual IC Time Burden (Hours) 190,000,000 0 122,000,000 0 0 68,000,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
PASSENGER DISCLOSURE AND ATTESTATION - Arabic Attachment D5 Fillable PDF Passenger disclosure and attestation Arabic.pdf 05/26/2021
PASSENGER DISCLOSURE AND ATTESTATION - Chinese Attachment D4 Fillable PDF Passenger disclosure and attestation Simplified Chinese.pdf 05/26/2021
PASSENGER DISCLOSURE AND ATTESTATION - French Attachment D6 Fillable PDF Passenger disclosure and attestation French.pdf 05/26/2021
PASSENGER DISCLOSURE AND ATTESTATION - Russian Attachment D3 -Fillable PDF Passenger disclosure and attestation Russian.pdf 05/26/2021
Passenger Disclosure and Attestation - English Attachment D2 -Fillable PDF Passenger disclosure and attestation English.pdf 05/26/2021
Passenger Disclosure and Attestation - Spanish Attachment D7 Fillable PDF Passenger disclosure and attestation Spanish.pdf 05/26/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.