CIS OMBudsman Case Assistance Form

CIS Ombudsman Case Assistance Form

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1601-0004 can be found here:

Documents and Forms

Document Name Document Type
CISOMB_Form_DHS-7001 Instructions.pdf Instruction
7001 Citizenship and Immigration Services Ombudsman CISOMB_DHS_Form7001_Electronic_042911.pdf Form and Instruction
DHS Form 7001 Citizenship and Immigration Services Ombudsman CISOMB_Form_DHS-7001.pdf Form

Information Collection (IC) Details

IC Title:	CIS Ombudsman Case Assistance Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			CISOMB_Form_DHS-7001 Instructions.pdf	Yes	No	Fillable Printable
Form and Instruction	7001	Citizenship and Immigration Services Ombudsman	CISOMB_DHS_Form7001_Electronic_042911.pdf	Yes	Yes	Fillable Fileable Signable
Form	DHS Form 7001	Citizenship and Immigration Services Ombudsman	CISOMB_Form_DHS-7001.pdf	Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,600	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	2,600	2,600
Annual IC Time Burden (Hours)	2,600	2,600
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.