Information Collection

Affidavit of Relationship

IC 200164 under ICR 201111-1405-010 · OMB 1405-0206.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0206 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DS-7656 Affidavit of Relationship	Form and Instruction
DS-7656 Affidavit of Relationship DS-7656 (2-2012).pdf	Form and Instruction
DS 7656 Affidavit of Relationship DS7656 OMB FINAL 07-16.pdf	Form and Instruction

IC Title:

Affidavit of Relationship

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DS-7656	Affidavit of Relationship	DS-7656 (2-2012).pdf		Yes	No	Fillable Printable
Form and Instruction	DS 7656	Affidavit of Relationship	DS7656 OMB FINAL 07-16.pdf		Yes	No	Fillable Printable

Line of Business: International Affairs and Commerce

Subfunction: International Development and Humanitarian Aid

Privacy Act System of Records

Title: Privacy Act; System of Records: State- 59, Refugee Case Records

FR Citation: 77 FR 24

Number of Respondents: 3,500

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,500	3,500
Annual IC Time Burden (Hours)	3,500	3,500
Annual IC Cost Burden (Dollars)	525,000	525,000

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.