Information Collection

Fee Waiver Request

IC 12674 under ICR 201408-1125-001 · OMB 1125-0003.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1125-0003 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1125-0003 E-26A Fee Waiver Request	Form and Instruction
1125-0003 E-26A Fee Waiver Request 1125-0003 E-26A Form and Written Narrative.pdf www.justice.gov/eoir/eoirforms/eoir26a.pdf	Form and Instruction
E-26A Fee Waiver Request eoir26a_01_15.pdf	Form and Instruction
1125-0003 E-26A Cover Letter.pdf 1125-0003 E-26A Cover Letter	IC Document
1125-0003 E-26A 83-I.pdf 1125-0003 E-26A 83-I	IC Document
1125-0003 E-26A Authority.pdf 1125-0003 E-26A Authority	IC Document
1125-0003 E-26A Supporting Statement.pdf 1125-0003 E-26A Supporting Statement	IC Document
1125-0003 E-26A Form and Written Narrative.pdf 1125-0003 E-26A Form and Narrative	IC Document

IC Title:

Fee Waiver Request

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 8 CFR 1003.8

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	1125-0003 E-26A	Fee Waiver Request	1125-0003 E-26A Form and Written Narrative.pdf	http://www.justice.gov/eoir/eoirforms/eoir26a.pdf	Yes	No	Fillable Printable
Form and Instruction	E-26A	Fee Waiver Request	eoir26a_01_15.pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records

Title: Records and Management Information System

FR Citation: 72 FR 3410

Number of Respondents: 8,614

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	8,614	2,644	5,970
Annual IC Time Burden (Hours)	8,614	2,644	5,970
Annual IC Cost Burden (Dollars)	86,140	26,440	59,700

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
1125-0003 E-26A Cover Letter	1125-0003 E-26A Cover Letter.pdf	08/05/2014
1125-0003 E-26A 83-I	1125-0003 E-26A 83-I.pdf	08/05/2014
1125-0003 E-26A Authority	1125-0003 E-26A Authority.pdf	08/05/2014
1125-0003 E-26A Supporting Statement	1125-0003 E-26A Supporting Statement.pdf	08/05/2014
1125-0003 E-26A Form and Narrative	1125-0003 E-26A Form and Written Narrative.pdf	08/05/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.