Information Collection

Supplement 1, Listing of Adult Member of the Household

IC 205557 under ICR 201406-1615-005 · OMB 1615-0028.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0028 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Supplement 1, List Supplement 1, Listing of Adult Member of the Household	Form
Supplement 1, List Supplement 1 I600(A)-Supp1-FRM-OMB REV-UAA-12192014.pdf	Form

IC Title:

Supplement 1, Listing of Adult Member of the Household

Agency IC Tracking Number:

Supplement 1

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 8 CFR 204.3

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	Supplement 1, Listing of Adult Member	Supplement 1	I600(A)-Supp1-FRM-OMB REV-UAA-12192014.pdf		Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: Inter-Country Adoptions Security

FR Citation: 72 FR 31086

Number of Respondents: 3,316

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	3,316	816	2,500
Annual IC Time Burden (Hours)	829	204	625
Annual IC Cost Burden (Dollars)	0	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.