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Biographical Information/Program Eligibility Questionnaire and Practitioner Fraud Pilot Program Initial Interview form
Biographical Information/Program Eligibility Questionnaire and Practitioner Fraud Pilot Program Initial Interview form
OMB: 1115-0245
IC ID: 12251
OMB.report
DOJ/INS
OMB 1115-0245
ICR 200111-1115-001
IC 12251
( )
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Biographical Information/Program Eligibility Questionnaire and Practitioner Fraud Pilot Program Initial Interview form
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.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
I-909
No
No
Form
I-908
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
5
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,000
0
1,000
0
0
0
Annual IC Time Burden (Hours)
5,000
0
5,000
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
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.