ICE Mutual Agreement between Government and Employers (IMAGE)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1653-0048 can be found here:

Documents and Forms

Document Name Document Type
Form 73-028 ICE Mutual Agreement between Government and Employers (IMAGE) Form and Instruction
73-028 IMAGE Assessment ICE_Form_73-028_2012_12_19].pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	ICE Mutual Agreement between Government and Employers (IMAGE)	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	73-028	IMAGE Assessment	ICE_Form_73-028_2012_12_19].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: 100	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	150	150
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.