Individual Followup with Tuberculosis (TB) Patients Referred by ICE

Information Collection for Tuberculosis Data from Referring Entities to CureTB

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1186 can be found here:

Documents and Forms

Document Name Document Type
Individual Followup with Tuberculosis (TB) Patients Referred by ICE Form and Instruction
CureTB Transnational Notificaiton Att. C - CureTB_Transnational Notification.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Individual Followup with Tuberculosis (TB) Patients Referred by ICE	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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 and Instruction	n/a	CureTB Transnational Notificaiton	Att. C - CureTB_Transnational Notification.pdf		No		Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title: 09-20-0171, Quarantine- and Traveler-related Activities Including Records for Contact Tracing Investigation and Notification under 42 CFR Parts 70 and 71	FR Citation: 72 FR 70867

Number of Respondents: 587	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	587	587
Annual IC Time Burden (Hours)	440	440
Annual IC Cost Burden (Dollars)	10,997	10,997

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.