Information Collection

Affidavit of Support Under Sction 213A of the Act, and Contract Between Sponsor and Household Member

IC 12173 under ICR 200106-1115-002 · OMB 1115-0214.

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Document Name	Document Type

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IC Title:

Affidavit of Support Under Sction 213A of the Act, and Contract Between Sponsor and Household Member

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	I-864				No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 950,300

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	950,300	360,300	590,000
Annual IC Time Burden (Hours)	2,443,350	1,884,850	558,500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

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