OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

[NCZEID] Report of Illness or Death: Interstate Travel of Persons (42 CFR part 70)

ICR 202603-0920-009 · OMB 0920-0488 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-26-0140 TB Aircraft Contact Investigation Outcome Reporting Form Form and Instruction New Available
Form 0920-26-0140 Rubella Contact Investigation Outcome Reporting Form – Air Form and Instruction New Available
Form 0920-26-0140 Measles Aircraft Contact Investigation Outcome Reporting Form Form and Instruction New Available
Form 0920-26-0140 General Aircraft Contact Investigation Outcome Reporting Form Form and Instruction New Available
Form 0920-26-0140 Domestic Manifest Order Template Form and Instruction New Available
Form 0920-26-0140 International Airline Manifest Order Template Form and Instruction New Available
Form 0920-26-0140 Passenger Locator Form - DOMESTIC Form and Instruction New Available
Form 0920-26-0140 Passenger Locator Form - INTERNATIONAL Form and Instruction New Available
Form 0920-26-0140 Air Travel Illness or Death Investigation Form Form and Instruction New Available
Form 0920-26-0140 42 CFR 71.33 Report by Persons in Isolation or Surveillance Form and Instruction New Available
Form 0920-26-0140 42 CFR 70.11 - Report of death or illness onboard aircraft operated by airline Form and Instruction Modified Available
Form 0920-26-0140 42 CFR 70.4 - Report by the master of a vessel or person in charge of conveyance of the incidence of a communicable disease occurring while in interstate travel Form and Instruction Modified Source copy available
Attachment K - CDC FAA Memorandum of Agreement.pdf Supplementary Document Uploaded 2026-03-23 Available
Attachment M - Non-researchDetermination_0920-0488.pdf Supplementary Document Uploaded 2026-03-23 Repair queued
Attachment B2 - 60-day FRN 0920-0488 Public Comment.docx Public Comments Uploaded 2026-03-23 Repair queued
Attachment B2 - 60-day FRN 0920-0488 Public Comments-3.19.26.docx Public Comments Uploaded 2026-03-23 Repair queued
Attachment A3 42 CFR 70.pdf Supplementary Document Uploaded 2026-03-23 Repair queued
Attachment A2 42 CFR 71.pdf Supplementary Document Uploaded 2026-03-23 Available
Attachment A1 Section 361 of the Public Health Service Act (42 USC 264).pdf Supplementary Document Uploaded 2026-03-23 Available
0920-0488 _30_Day_FRN_Notice_Clean.docx Supplementary Document Uploaded 2026-03-23 Repair queued
Attachment F 0920-0488 CDC Non-research determination.pdf Supplementary Document Uploaded 2022-06-24 Repair queued
Attachment E Privacy Impact Assessment.pdf Supplementary Document Uploaded 2022-06-24 Available
Attachment D CDC FAA Memorandum of Agreement.pdf Supplementary Document Uploaded 2022-06-24 Repair queued
Attachment C Public Comment-0920-0488-Final.docx Supplementary Document Uploaded 2022-06-24 Repair queued
Attachment B 60-Day FRN-4.1.2022.pdf Supplementary Document Uploaded 2022-06-24 Available
SSB_0920-0488Aviation-RelatedPublicHealthActivities_30d_Final.docx Supporting Statement B Uploaded 2026-03-23 Repair queued
SSA_0920-0488.docx Supporting Statement A Uploaded 2026-03-23 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
279581 TB Aircraft Contact Investigation Outcome Reporting Form Form and Instruction NewTB Aircraft Contact Investigation Outcome Reporting Form
279581 TB Aircraft Contact Investigation Outcome Reporting Form Form and Instruction New
279580 Rubella Contact Investigation Outcome Reporting Form – Air Form and Instruction NewRubella Contact Investigation Outcome Reporting Form – Air
279580 Rubella Contact Investigation Outcome Reporting Form – Air Form and Instruction New
279579 Measles Contact Investigation Outcome Reporting Form – Air Form and Instruction NewMeasles Aircraft Contact Investigation Outcome Reporting Form
279579 Measles Contact Investigation Outcome Reporting Form – Air Form and Instruction New
279578 General Contact Investigation Outcome Reporting Form -Air Form and Instruction NewGeneral Aircraft Contact Investigation Outcome Reporting Form
279578 General Contact Investigation Outcome Reporting Form -Air Form and Instruction New
279577 Domestic Airline Manifest Order Template Form and Instruction NewDomestic Manifest Order Template
279577 Domestic Airline Manifest Order Template Form and Instruction New
279576 International Airline Manifest Order Template Form and Instruction NewInternational Airline Manifest Order Template
279576 International Airline Manifest Order Template Form and Instruction New
279575 Public Health Passenger Locator Form: limited onboard exposure* (domestic flights) Form and Instruction NewPassenger Locator Form - DOMESTIC
279575 Public Health Passenger Locator Form: limited onboard exposure* (domestic flights) Form and Instruction New
279574 Public Health Passenger Locator Form: limited onboard exposure* (international flights) Form and Instruction NewPassenger Locator Form - INTERNATIONAL
279574 Public Health Passenger Locator Form: limited onboard exposure* (international flights) Form and Instruction New
279573 Air Travel Illness or Death Investigation Form Form and Instruction NewAir Travel Illness or Death Investigation Form
279573 Air Travel Illness or Death Investigation Form Form and Instruction New
279572 42 CFR 71.33 Report by Persons in Isolation or Surveillance Form and Instruction New42 CFR 71.33 Report by Persons in Isolation or Surveillance
279572 42 CFR 71.33 Report by Persons in Isolation or Surveillance Form and Instruction New
234025 42 CFR 70.11 Report of death or illness onboard aircraft operated by airline Form and Instruction Modified42 CFR 70.11 - Report of death or illness onboard aircraft operated by airline
234025 42 CFR 70.11 Report of death or illness onboard aircraft operated by airline Form and Instruction Modified
205723 42 CFR 71.21 - Death/Illness Reports from Aircraft Form and Instruction Modified42 CFR 70.4 - Report by the master of a vessel or person in charge of conveyance of the incidence of a communicable disease occurring while in interstate travel
205723 42 CFR 71.21 - Death/Illness Reports from Aircraft Form and Instruction Modified
ICR Details
0920-0488 202603-0920-009
Received in OIRA 202206-0920-013
HHS/CDC 0920-26-0140
[NCZEID] Report of Illness or Death: Interstate Travel of Persons (42 CFR part 70)
Revision of a currently approved collection   No
Regular 03/23/2026
  Requested Previously Approved
36 Months From Approved 04/30/2026
6,535 1,600
2,583 186
0 0
The goal of this information collection is to ensure that CDC can collect data related to communicable diseases or deaths that occur aboard conveyances during interstate travel within the United States. Data is used by CDC to assess and respond to reports of communicable disease or death that occur on conveyances engaged in interstate travel, and assist state and local health authorities if an illness or death occurs that poses a risk to public health. As required by regulation, all instances of communicable disease characterized by certain signs and symptoms must be reported to the local health authority with jurisdiction over the arrival port. CDC has accepted reports to CDC as fulfilling this requirement. CDC also requests reports of all deaths occurring during domestic flights. In this Revision, CDC is consolidating several aviation‑related information collections under one OMB control number to streamline PRA submissions and align burden estimates with current post‑COVID‑19 reporting levels. Multiple forms were updated to reflect new terminology, revised exposure and symptom fields, updated security and submission instructions, and alignment with Executive Order 14168 by replacing “gender” with “sex.” Most affected tools also had their OMB Control Numbers updated to 0920‑0488 for consistency.
US Code: 42 USC 241 Name of Law: Public Health Service Act
   US Code: 42 USC 70-71 Name of Law: Interstate Quarantine
  
EO: EO 14168
Not associated with rulemaking
  91 FR 1316 01/13/2026
91 FR 12806 03/17/2026
Yes
12
IC Title Form No. Form Name
42 CFR 70.11 Report of death or illness onboard aircraft operated by airline 0920-26-0140 42 CFR 70.11 - Report of death or illness onboard aircraft operated by airline
42 CFR 71.21 - Death/Illness Reports from Aircraft 0920-26-0140 42 CFR 70.4 - Report by the master of a vessel or person in charge of conveyance of the incidence of a communicable disease occurring while in interstate travel
42 CFR 71.33 Report by Persons in Isolation or Surveillance 0920-26-0140 42 CFR 71.33 Report by Persons in Isolation or Surveillance
Air Travel Illness or Death Investigation Form 0920-26-0140 Air Travel Illness or Death Investigation Form
Domestic Airline Manifest Order Template 0920-26-0140 Domestic Manifest Order Template
General Contact Investigation Outcome Reporting Form -Air 0920-26-0140 General Aircraft Contact Investigation Outcome Reporting Form
International Airline Manifest Order Template 0920-26-0140 International Airline Manifest Order Template
Measles Contact Investigation Outcome Reporting Form – Air 0920-26-0140 Measles Aircraft Contact Investigation Outcome Reporting Form
Public Health Passenger Locator Form: limited onboard exposure* (domestic flights) 0920-26-0140 Passenger Locator Form - DOMESTIC
Public Health Passenger Locator Form: limited onboard exposure* (international flights) 0920-26-0140 Passenger Locator Form - INTERNATIONAL
Rubella Contact Investigation Outcome Reporting Form – Air 0920-26-0140 Rubella Contact Investigation Outcome Reporting Form – Air
TB Aircraft Contact Investigation Outcome Reporting Form 0920-26-0140 TB Aircraft Contact Investigation Outcome Reporting Form
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 6,535 1,600 0 3,407 1,528 0
Annual Time Burden (Hours) 2,583 186 0 715 1,682 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
CDC is requesting a 3‑year approval to consolidate several aviation‑related information collections under one OMB control number, resulting in a total of 2,585 estimated burden hours.
$750,918
Yes Part B of Supporting Statement
    Yes
    No
No
No
No
Yes
Odion Clunis 770 488-0045 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/23/2026