Information Collection

Information Relating to Beneficiary of Private Bill

IC 21013 under ICR 202202-1653-005 · OMB 1653-0026.

Documents and Forms

Document Name Document Type
Form G-79A Information Relating to Beneficiary of Private Bill Form and Instruction
G-79A Information Related to Beneficiary of Private Bill Form G-79A.pdf www.ice.gov/forms Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Information Relating to Beneficiary of Private Bill	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 8 CFR 212

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	G-79A	Information Related to Beneficiary of Private Bill	Form G-79A.pdf	https://www.ice.gov/forms	Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 35	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	35	35
Annual IC Time Burden (Hours)	53	53
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.