Information Collection

Cuban Remittance Affidavit

IC 15193 under ICR 200909-1505-001 · OMB 1505-0167.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0167 can be found here:

Documents and Forms

Document Name Document Type
Form TD-F-90-22.52 Cuban Remittance Affidavit Form
TD-F-90-22.52 Cuba Remittance Affidavit (Currently Approved) Cuba Remittance Affidavit Form.pdf www.treas.gov/offices/enforcement/ofac/programs/cuba/forms/caffidav.pdf Form
TD-F-90-22.52 Cuba Remittance Affidavit (Revised) Cuban Remittance AFFIDAVIT1.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Cuban Remittance Affidavit	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	TD-F-90-22.52	Cuba Remittance Affidavit (Currently Approved)	Cuba Remittance Affidavit Form.pdf	http://www.treas.gov/offices/enforcement/ofac/programs/cuba/forms/caffidav.pdf	Yes	No	Printable Only
Form	TD-F-90-22.52	Cuba Remittance Affidavit (Revised)	Cuban Remittance AFFIDAVIT1.pdf		Yes	No	Printable Only

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,100,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,900,000	3,900,000
Annual IC Time Burden (Hours)	65,000	65,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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