APPLICATION FOR ISSUANCE OF REFUGEE TRAVEL DOCUMENT (ARTICLE 28 UNITED NATIONS CONVENTION OF JULY 28, 1951, AND PROTOCOL OF 1967 (RELATING TO STATUS OF REFUGEES, 8 CFR 223A
ICR 198906-1115-008
OMB: 1115-0084
Federal Form Document
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APPLICATION FOR ISSUANCE OF
REFUGEE TRAVEL DOCUMENT (ARTICLE 28 UNITED NATIONS CONVENTION OF
JULY 28, 1951, AND PROTOCOL OF 1967 (RELATING TO STATUS OF
REFUGEES, 8 CFR 223A
'REFUGEE,' 'DOCUMENT,' 'ALIEN,'
'INFORMATION' USED TO OBTAIN DATA NECESSARY FOR DETERMINATION OF
APPLICANT'S ELIGIBILITY FOR ISSUANCE OF REFUGEE TRAVEL DOCUMENT.
FORM IS FILED BY ANY ALIEN PHYSICALLY PRESENT IN THE UNITED STATES,
WHOSE PRESENCE IS LAWFUL AND WHO IS A REFUGEE UNDER SECTION
101(A)(42)A OF ACT.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.