OMB control number

[NCEZID] Maritime-related Public Health Activities

OMB 0920-1335 · HHS/CDC.

OMB 0920-1335

Latest Forms, Documents, and Supporting Material

Document Name
General Maritime Contact Investigation Outcome Reporting Worksheet Form and Instruction
Varicella Outbreak Reporting Form Form and Instruction
TB Maritime Investigation Worksheet Form
Maritime Conveyance Illness or Death Investigation Form Form and Instruction
Maritime Conveyance Illness or Death Investigation Form Form and Instruction
Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form Form and Instruction
Form 0920-1335 Attachment E_Notice of Participation-Nonparticipation Form
Form 0920-1335 Attachment F_Cruise Ship Vaccination Status Classification Form
Form 0920-1335 Attachment L_Cruise COVID19 Contact Investigation Worksheet Form
Form 0920-1335 Attachment K_Cruise COVID19 Case Investigation Worksheet Form
Form 0920-1335 COVID-19 Case Investigation worksheet Form
Form 0920-1335 Attachment O_Agreement with Housing Facility Form
Form 0920-1335 Attachment M_Agreement with Port of Entry Form
Form 0920-1335 Attachment N_Agreement with Health Care Organization Form
Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form Form and Instruction
Attachment B2 - 60-day FRN 0920-1335 Notice Public Comment.docx Public Comments
Attachment I - 0920-1335_NonResearchDetermination_Signed-3.9.2026.pdf Supplementary Document
Attachment H - QARS_PIA.pdf Supplementary Document
Attachment B1 - 60-day FRN 0920-1335 Notice (Jan. 15, 2026).pdf Supplementary Document
SSB_0920-1335Maritime-relatedPublicHealthActivities_30d_final.docx Supporting Statement B
Attachment A2 42 CFR 71.pdf Supplementary Document
Attachment A3 42 CFR 70.pdf Supplementary Document
Attachment A1 Section 361 of the Public Health Service Act (42 USC 264).pdf Supplementary Document
SSA_0920-1335Maritime-relatedPublicHealthActivities_30d_final_final.docx Supporting Statement A
General Maritime Contact Investigation Outcome Reporting Form Form and Instruction
Varicella Outbreak Enhanced Data Collection Form - Maritime Form and Instruction
TB Maritime Contact Investigation Worksheet Form
Maritime Conveyance Illness or Death Investigation Form [Section 5] Form and Instruction
Maritime Conveyance Illness or Death Investigation Form [Sections 1-4] Form and Instruction
Report of Death Illness During Stay in Port (Verbal-No Form) Other-OMB Header and Burden Statement
Report of Death Illness from Ship (Verbal-No Form) Other-OMB Header and Burden Statement
Cruise Ship Cumulative Acute Respiratory Illness (submitted sooner than 24 hours before arrival in U.S because 3% or more of the voyage's passengers or crew have ARI) Form and Instruction
COVID-19 Program for Cruise Ships Notice of Participation/Nonparticipation Form
Cruise Ship Vaccination Status Classification Form
Cruise Ship Physician - COVID-19 Contact Investigation Worksheet (if necessary) Form
Cruise Ship Physician - COVID-19 Case Investigation Worksheet (if necessary) Form
Cruise Ship Physician - COVID-19 Case Investigation Worksheet (if necessary) Form
Cruise Ship Operator - Remote and In-person Inspections Instruction
Cruise Ship Brand/Operator - Agreement with Housing Facility with signoff from Local Health Authorities Form
Cruise Ship Brand/Operator - Agreement with Housing Facility with signoff from Local Health Authorities Instruction
Cruise Ship Operator - Agreement with Port of Entry with signoff from Local Health Authority Form
Cruise Ship Operator - Agreement with Port of Entry with signoff from Local Health Authority Instruction
Cruise Ship Brand/Operator - Agreement with Health Care Organization with signoff from Local Health Authorities Form
Cruise Ship Brand/Operator - Agreement with Health Care Organization with signoff from Local Health Authorities Instruction
Cruise Ship Cumulative Acute Respiratory Illness (ARI) Reporting Form (submitted once per voyage, within 24 hours before arrival in U.S.) Form and Instruction
Cruise Ship Holding Company - COVID-19 Response Plan Instruction

All Historical Document Collections

202603-0920-015	Reinstatement with change of a previously approved collection	2026-04-14
202310-0920-011 Approved without change	No material or nonsubstantive change to a currently approved collection	2023-10-31
202306-0920-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2023-06-07
202303-0920-003 Approved without change	No material or nonsubstantive change to a currently approved collection	2023-03-08
202203-0920-006 Approved without change	Revision of a currently approved collection	2022-03-16
202110-0920-007 Approved without change	Extension without change of a currently approved collection	2021-10-28
202108-0920-009 Approved without change	No material or nonsubstantive change to a currently approved collection	2021-08-12
202105-0920-012 Approved without change	No material or nonsubstantive change to a currently approved collection	2021-05-28
202105-0920-004 Approved with change	No material or nonsubstantive change to a currently approved collection	2021-05-06
202104-0920-004 Approved with change	Existing collection in use without an OMB Control Number	2021-04-19