Information Collection

Applicants With a Class A Tuberculosis Condition (As Defined by HHS Regulations)

IC 214079 under ICR 201411-1615-008 · OMB 1615-0032.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0032 can be found here:

Documents and Forms

Document Name Document Type
Applicants With a Class A Tuberculosis Condition (As Defined by HHS Regulations) Form
Applicants With a Class A Tuberculosis Condition (As Def I690-SUPP-FRM-30Day-02252015.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Applicants With a Class A Tuberculosis Condition (As Defined by HHS Regulations)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 8 CFR 245a (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	None	Applicants With a Class A Tuberculosis Condition (As Defined by HHS)	I690-SUPP-FRM-30Day-02252015.pdf		Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: USCIS Benefits Services System	FR Citation: 73 FR 56763

Number of Respondents: 11	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	11	11
Annual IC Time Burden (Hours)	22	22
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.