Information Collection

Contract Between Sponsor and Household Member

IC 204184 under ICR 202508-1615-017 · OMB 1615-0075.

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Information Collection (IC) Details

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IC Title:	Contract Between Sponsor and Household Member	Agency IC Tracking Number:	I-864A

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 8 CFR 213A (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

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: USCIS Benefits Information System	FR Citation: 81 FR 72069

Number of Respondents: 215,800	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	215,800	0	215,800
Annual IC Time Burden (Hours)	269,750	-53,950	323,700
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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