Information Collection

Cure TB Transnational Notification - Referral from Local Health Departments

IC 226736 under ICR 202203-0920-003 · OMB 0920-1186.

⚠️ Notice: This information collection may be referencing outdated material.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
Cure TB Transnational Notification - Referral from Local Health Departments Form and Instruction
CureTB Transnational Notification Att. C - CureTB_Transnational Notification.pdf Form and Instruction
CureTB Transnational Notification Att. C - CureTB_Transnational Notification.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Cure TB Transnational Notification - Referral from Local Health Departments	Agency IC Tracking Number:	16AWE

Is this a Common Form? No		IC Status: Unchanged

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 Notification	Att. C - CureTB_Transnational Notification.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	FR Citation: 72 FR 70867

Number of Respondents: 70	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	280	280
Annual IC Time Burden (Hours)	140	140
Annual IC Cost Burden (Dollars)	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.