Information Collection

Document Verification Request and Document Verification Request Supplement

IC 21025 under ICR 201105-1615-006 · OMB 1615-0101.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0101 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
G-845 inst 02-14-2011_updated 12-09-11.pdf	Instruction
G-845 Supplement instr 05-20-2011_updated 12-09-11.pdf	Instruction
Web Screen Shots Verification Information System WEB-3 Screen Shots Updated 12-14-11.doc	Form
G-845 Document Verification Request G-845 02-14-2011.pdf	Form
G-845 Supplement Document Verification Request Supplement G-845 Supplement 05-20-2011.pdf	Form

IC Title:

Document Verification Request and Document Verification Request Supplement

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			G-845 inst 02-14-2011_updated 12-09-11.pdf	Yes	No	Printable Only
Form	G-845 Supplement	Document Verification Request Supplement	G-845 Supplement 05-20-2011.pdf	Yes	No	Fillable Printable
Form	Web Screen Shots	Verification Information System	WEB-3 Screen Shots Updated 12-14-11.doc	Yes	Yes	Fillable Fileable
Form	G-845	Document Verification Request	G-845 02-14-2011.pdf	Yes	No	Fillable Printable
Instruction			G-845 Supplement instr 05-20-2011_updated 12-09-11.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: 12,099,345

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 98 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	12,099,345	0	1,861,113	10,238,232
Annual IC Time Burden (Hours)	1,004,246	0	154,473	849,773
Annual IC Cost Burden (Dollars)	6,416,358	4,613,784	0	1,802,574

Documents for IC

table that charts IC Documents
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.