Request for Fee Waiver

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0116 can be found here:

Documents and Forms

Document Name Document Type
I-912P pdf 07222011_LJN .pdf Other-Poverty Guidelines
I-912 Instr FINAL Rev 07262011.pdf Instruction
I-912 Request for Fee Waiver I-912 Form Rev 07222011 Per DS.pdf uscis.gov Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Fee Waiver	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 8 CFR 103

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Poverty Guidelines			I-912P pdf 07222011_LJN .pdf		Yes	No	Printable Only
Form	I-912	Request for Fee Waiver	I-912 Form Rev 07222011 Per DS.pdf	uscis.gov	Yes	No	Fillable Fileable
Instruction			I-912 Instr FINAL Rev 07262011.pdf		Yes	No	Printable Only

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: USCIS Benefits Information System	FR Citation: 73 FR 56596

Number of Respondents: 85,000	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	85,000	85,000
Annual IC Time Burden (Hours)	99,110	99,110
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.