Information Collection

Marriage & Dissolution Applications, 25 CFR 600(c) and 606(c)

IC 11464 under ICR 201504-1076-001 · OMB 1076-0094.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1076-0094 can be found here:

Documents and Forms

Document Name Document Type
Marriage & Dissolution Applications, 25 CFR 600(c) and 606(c) Form and Instruction
Marriage License Application MARRIAGE LICENSE APPLICATION xx-xx-20xx exp.rtf Form and Instruction
Application for Dissolution of Marriage APPLICATION DISSOLUTION MARRIAGE xx.xx.20xx exp.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Marriage & Dissolution Applications, 25 CFR 600(c) and 606(c)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 25 CFR 11.606(c) 25 CFR 11.600(c)

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	Marriage License Application	MARRIAGE LICENSE APPLICATION xx-xx-20xx exp.rtf		No		Paper Only
Form and Instruction	N/A	Application for Dissolution of Marriage	APPLICATION DISSOLUTION MARRIAGE xx.xx.20xx exp.doc		No		Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 260	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	260	0	260
Annual IC Time Burden (Hours)	65	0	65
Annual IC Cost Burden (Dollars)	6,500	6,500	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.