View Information Collection (IC)

View Information Collection (IC)

IC Title:	Air Traveler (for illness or deathinvestigation) Air Travel Illness or Death Investigation or Traveler Follow-up Form	Agency IC Tracking Number:	0920-1318

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-1318	Air Travel Illness or Death Investigation or Traveler Follow-up Form	Attachment E-Air Travel Illness or Death Investigation or Traveler Follow up Form.pdf	NA	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0171 Quarantine- and Traveler-related Activities	FR Citation: 83 FR 6591

Number of Respondents: 10,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	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	10,000	0	-55,000	0	0	65,000
Annual IC Time Burden (Hours)	2,500	0	-13,750	0	0	16,250
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.