Information Collection

Statement In Support Of Application For Waiver Of Excludability Under Sections 212(a)(1) And (3) Of Immigration And Nationality Act

IC 165622 under ICR 198503-0920-004 · OMB 0920-0006.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0006 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	STATEMENT IN SUPPORT OF APPLICATION FOR WAIVER OF EXCLUDABILITY UNDER SECTIONS 212(A)(1) AND (3) OF IMMIGRATION AND NATIONALITY ACT	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	CDC 4.422.1	No	No
Form	4.422-2	No	No
Form	4.422-4	No	No
Form	4.422-5	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000	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	850	-1,150	2,000
Annual IC Time Burden (Hours)	75	-233	308
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

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