Information Collection Request
Report of Medical Examination and Vaccination Record
ICR 202209-1615-003 · OMB 1615-0033 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1615-0033 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form I-693 Report of Medical Examination and Vaccination Record |
Form | Modified | Repair queued |
 I-693-011 REV Supporting Statement 20221003.docx |
Supporting Statement A | Uploaded 2022-10-04 | Repair queued |
| I693-011-INS-TOC-REV-OMBReview-10032022.docx |
Supplementary Document | Uploaded 2022-10-04 | Repair queued |
| I693-011-FRM-TOC-REV-OMBReview-10032022.docx |
Supplementary Document | Uploaded 2022-10-04 | Repair queued |
 I693-011 30dayFRN 87 FR 50348 2022-17529.pdf |
Supplementary Document | Uploaded 2022-09-27 | Repair queued |
| I-693-011-REV-60-DayFRN-87-FR-35241_2022-12411.pdf |
Supplementary Document | Uploaded 2022-09-27 | Repair queued |
| SORN 007 Benefits Info Sys 2016 10 19.pdf |
Supplementary Document | Uploaded 2019-02-05 | Missing upstream |
| SORN 001 AFileIndexNFTS 2017 09 18.pdf |
Supplementary Document | Uploaded 2019-02-05 | Repair queued |
| privacy-pia-uscis-067-civilsurgeon-june1,2017.pdf |
Supplementary Document | Uploaded 2019-02-05 | Repair queued |
| privacy-pia-003-uscis-iddmp-sept24,2013.pdf |
Supplementary Document | Uploaded 2019-02-05 | Repair queued |
 Reference citations.doc |
Supplementary Document | Uploaded 2019-02-05 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 20305 |  Report of Medical Examination and Vaccination Record |
Form | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | DHS/USCIS |
| OMB Control No | 1615-0033 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202201-1615-003 |
| Agency Tracking No | I-693 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |