Information Collection

Quarantine Release

IC 206054 under ICR 201611-0920-007 · OMB 0920-0263.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0263 can be found here:

Documents and Forms

Document Name Document Type
Data Elements Quarantine Release.doc Other-Data Elements

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Quarantine Release	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Data Elements			Data Elements Quarantine Release.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title: 09-20-0171 Quarantine and Traveler Related Activities, Including Records for Contact Tracing, Investigation, and Notification Under 42 CFR Part 70-71	FR Citation: 72 FR 70867

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	38	38
Annual IC Cost Burden (Dollars)	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.