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Federal forms, ICRs, and supporting documents

Information Collection

Cumulative Influenza/Influenza-Like Illness (ILI) Form

IC 234012 under ICR 202603-0920-008 · OMB 0920-0134.

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Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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Cumulative Influenza/Influenza-Like Illness (ILI) Form
 
No Removed
 
Mandatory
 
42 CFR 71

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction none Cumulative Influenza/Influenza-Like Illness (ILI) Form Attachment E - Maritime Conveyance Cumulative Influenza or Influenza-Like Illness (ILI) Form.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

Quarantine- and Traveler-Related Activities, Including Records for Tracing Contact Investigation  72 FR 7086

3,000 0
   
Private Sector Businesses or other for-profits
 
   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 0 0 -3,000 0 0 3,000
Annual IC Time Burden (Hours) 0 0 -100 0 0 100
Annual IC Cost Burden (Dollars) 0 0 -3,893 0 0 3,893

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