Cure TB Transnational Notification (referral from LHDs)

[NCEZID] Information Collection for Tuberculosis Data from Referring Entities to CureTB

Documents and Forms

Document Name Document Type
Form CS347315-A (02/01/ Cure TB Transnational Notification (referral from LHDs) Form and Instruction
CS347315-A (02/01/ CureTB Transnational Notification Att. C- CureTBTransnational Notification-v2-508.pdf Form and Instruction
CS347315-A (02/01/ CureTB Transnational Notification Att. C- CureTBTransnational Notification-v2-508.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Cure TB Transnational Notification (referral from LHDs)	Agency IC Tracking Number:	0920-1186

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 and Instruction	CS347315-A (02/01/2024)	CureTB Transnational Notification	Att. C- CureTBTransnational Notification-v2-508.pdf		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

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, HHS/CDC/CCID.	FR Citation: 72 FR 70867

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	300	20	280
Annual IC Time Burden (Hours)	150	10	140
Annual IC Cost Burden (Dollars)	0	-6,244	6,244

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.