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Traveler-based Genomic Surveillance Questionnaire
[NCEZID] Traveler-based Genomic Surveillance
OMB: 0920-1406
IC ID: 259028
OMB.report
HHS/CDC
OMB 0920-1406
ICR 202308-0920-006
IC 259028
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1406 can be found here:
2024-04-10 - No material or nonsubstantive change to a currently approved collection
2024-01-04 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Traveler-based Genomic Surveillance Questionnaire
Form
Information Collection Instrument
Attachment 3 - Information Collection instrument.docx
Form
Attachment 4C - Potential additional questions.docx
Potential Additional Questions
IC Document
Attachment 4C - TGS potential additional questions_RSVclean.docx
Att 4C_TGS_Additional Questions
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Traveler-based Genomic Surveillance Questionnaire
Agency IC Tracking Number:
0920-1406-23HP
Is this a Common Form?
No
IC Status:
Modified
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
n/a
Information Collection Instrument
Attachment 3 - Information Collection instrument.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
555,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
90 %
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
555,000
0
0
0
0
555,000
Annual IC Time Burden (Hours)
46,250
0
0
0
0
46,250
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Potential Additional Questions
Attachment 4C - Potential additional questions.docx
03/09/2023
Att 4C_TGS_Additional Questions
Attachment 4C - TGS potential additional questions_RSVclean.docx
08/11/2023
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.