Information Collection

Supplemental Registration for the Diversity Immigrant Visa Program

IC 14935 under ICR 201210-1405-005 · OMB 1405-0098.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DSP-122 Supplemental Registration for the Diversity Immigrant Visa Program	Form and Instruction
DSP-122 Supplemental Registration for the Diversity Immigrant Vi REVISED DSP-0122 (03-2013).pdf www.state.gov/documents/organization/80148.pdf	Form and Instruction

IC Title:

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DSP-122	Supplemental Registration for the Diversity Immigrant Visa Program	REVISED DSP-0122 (03-2013).pdf	http://www.state.gov/documents/organization/80148.pdf	Yes	No	Fillable Printable

Line of Business: International Affairs and Commerce

Subfunction: Foreign Affairs

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 60,000

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	Previously Approved
Annual Number of Responses for this IC	60,000	60,000
Annual IC Time Burden (Hours)	30,000	30,000
Annual IC Cost Burden (Dollars)	0	0

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.