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Air Traveler (for illness or deathinvestigation) Air Travel Illness or Death Investigation or Traveler Follow-up Form
REQUIREMENT FOR PROOF OF COVID-19 VACCINATION FOR NONCITIZEN, NONIMMIGRANT AIR PASSENGERS
OMB: 0920-1318
IC ID: 250047
OMB.report
HHS/CDC
OMB 0920-1318
ICR 202206-0920-014
IC 250047
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1318 can be found here:
2022-12-27 - Revision of a currently approved collection
2022-12-13 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 0920-1318
Air Traveler (for illness or deathinvestigation) Air Travel Illness or Death Investigation or Traveler Follow-up Form
Form
0920-1318 Air Travel Illness or Death Investigation or Traveler Fo
Attachment F-Air Travel Illness or Death Investigation or Traveler Follow up Form.pdf
Form
0920-1318 Air Travel Illness or Death Investigation or Traveler Fo
Attachment F-Air Travel Illness or Death Investigation or Traveler Follow up Form.pdf
Form
0920-1318 Air Travel or Death Investigation orTraveler Follow-up F
Attachment F-Air Travel Illness or Death Investigation or Traveler Follow up Form.pdf
Form
0920-1318 Air Travel or Death Investigation orTraveler Follow-up F
Attachment F-Air Travel Illness or Death Investigation or Traveler Follow up Form.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Air Traveler (for illness or deathinvestigation) Air Travel Illness or Death Investigation or Traveler Follow-up Form
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
0920-1318
Air Travel Illness or Death Investigation or Traveler Follow-up Form
Attachment F-Air Travel Illness or Death Investigation or Traveler Follow up Form.pdf
NA
Yes
Yes
Fillable Fileable
Form
0920-1318
Air Travel or Death Investigation orTraveler Follow-up Form
Attachment F-Air Travel Illness or Death Investigation or Traveler Follow up Form.pdf
NA
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
09-20-0171 Quarantine- and Traveler-related Activities
FR Citation:
83 FR 6591
Number of Respondents:
65,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
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
65,000
0
0
0
0
65,000
Annual IC Time Burden (Hours)
16,250
0
0
0
0
16,250
Annual IC Cost Burden (Dollars)
0
0
0
0
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.