Information Collection

State/Local TB Outcoming Reporting (Air)

IC 197946 under ICR 201802-0920-005 · OMB 0920-0900.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0900 can be found here:

Documents and Forms

Document Name Document Type
State/Local TB Outcoming Reporting (Air) Form
TB Contact Investigation Outcome Reporting Form - Air Attachment H -TB Outcome Reporting Form Air Travel.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	State/Local TB Outcoming Reporting (Air)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Form	n/a	TB Contact Investigation Outcome Reporting Form - Air	Attachment H -TB Outcome Reporting Form Air Travel.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 0920-0171 Quarantine and Traveler Related Activities, Including Records for Cpmtact Tracing Investigation and Notification under 42 CFR Parts 70 and 71	FR Citation: 72 FR 70867

Number of Respondents: 547	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	547	-697	1,244
Annual IC Time Burden (Hours)	46	-58	104
Annual IC Cost Burden (Dollars)	1,701	1,701	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.