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Federal forms, ICRs, and supporting documents

Information Collection Request

Statement for Exempt Individuals and Individuals With a Medical Condition

ICR 200208-1545-016 · OMB 1545-1411 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
18266 Statement for Exempt Individuals and Individuals With a Medical Condition Form Migrated
ICR Details
1545-1411 200208-1545-016
Historical Active 199908-1545-009
TREAS/IRS
Statement for Exempt Individuals and Individuals With a Medical Condition
Extension without change of a currently approved collection   No
Regular
Approved without change 10/03/2002
Retrieve Notice of Action (NOA) 08/14/2002
  Inventory as of this Action Requested Previously Approved
10/31/2005 10/31/2005 10/31/2002
150,000 0 150,000
174,345 0 177,120
0 0 0
Form 8843 is used by an alien individual to explain the basis of the individual's claim that he or she is able to exclude days of presence in the U.S. because the individual is a teacher/trainee or student; professional athlete; or has a medical condition or problem.
None
None
No
1
IC Title Form No. Form Name
Statement for Exempt Individuals and Individuals With a Medical Condition 8843
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 150,000 150,000 0 0 0 0
Annual Time Burden (Hours) 174,345 177,120 0 -2,775 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
08/14/2002