Information Collection

Covid-19 Contact Tracing

IC 242419 under ICR 202006-1601-001 · OMB 1601-0027.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1601-0027 can be found here:

Documents and Forms

Document Name Document Type
COVID-19 Contact Tracing Form.docx Other-Mock Up
COVID-19 Contact Tracing Script- Interview of COVID POSITIVE DHS Personnel.docx Other-Interview Script
COVID-19 Contact Tracing Notification Script- DHS Personnel.docx Other-Notifiation Script

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Covid-19 Contact Tracing	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Mock Up	COVID-19 Contact Tracing Form.docx	Yes	Yes	Fillable Fileable
Other-Interview Script	COVID-19 Contact Tracing Script- Interview of COVID POSITIVE DHS Personnel.docx	No		Fillable Fileable
Other-Notifiation Script	COVID-19 Contact Tracing Notification Script- DHS Personnel.docx	No		Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	167	167
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.