Information Collection

Health amd Human Services Statistical Data for Refugee/Asylee Adjusting Status

IC 20384 under ICR 201210-1615-003 · OMB 1615-0070.

Documents and Forms

Document Name Document Type
Form I-643 Health amd Human Services Statistical Data for Refugee/Asylee Adjusting Status Form and Instruction
I-643 Health and Human Services Statistical Data for Refugee/A I-643 Form and Instructions.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Health amd Human Services Statistical Data for Refugee/Asylee Adjusting Status	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 8 CFR 207

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	I-643	Health and Human Services Statistical Data for Refugee/Asylee Adjusting Status	I-643 Form and Instructions.pdf		Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: USCIS Benefits Information System	FR Citation: 73 FR 56596

Number of Respondents: 195,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	195,000	195,000
Annual IC Time Burden (Hours)	178,620	178,620
Annual IC Cost Burden (Dollars)	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.