Information Collection Request
[NCEZID] Statement in Support of Application for Waiver of Inadmissibility Under Immigration and Nationality Act
ICR 202401-0920-001 · OMB 0920-0006 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0920-0006 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form 4.422-1 Application for Waiver of Inadmissibility Under Immigration and Nationality Act (Form 4-422-1) |
Form and Instruction | Modified | Missing upstream |
 Attachment F Privacy Impact Assessment.pdf |
Supplementary Document | Uploaded 2024-01-17 | Repair queued |
| Attachment D Human Research Determination.pdf |
Supplementary Document | Uploaded 2024-01-02 | Repair queued |
 Supporting Statement B 2023.docx |
Supporting Statement B | Uploaded 2024-01-17 | Repair queued |
| Supporting Statement A 2023.docx |
Supporting Statement A | Uploaded 2024-01-17 | Repair queued |
| Attachment A3 8 CFR 212.7 Waiver of certain grounds of excludability.pdf |
Supplementary Document | Uploaded 2024-01-17 | Repair queued |
| Attachment A2 42 CFR Part 34 Medical Examination of Aliens.pdf |
Supplementary Document | Uploaded 2024-01-17 | Missing upstream |
| Attachment A1 8 USC 1182.pdf |
Supplementary Document | Uploaded 2024-01-17 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 6595 |  Application for Waiver of Inadmissibility Under Immigration and Nationality Act (Form 4-422-1) |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CDC |
| OMB Control No | 0920-0006 |
| Type of Information Collection | Reinstatement with change of a previously approved collection |
| Previous ICR Reference No | 202006-0920-005 |
| Agency Tracking No | 0920-0006 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |