Request for Fee Waiver

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0116 can be found here:

Documents and Forms

Document Name Document Type
i-912p.pdf Other-Poverty Guidelines
I912-INS-OMBReview-04152016.pdf Instruction
I-912 Request for Fee Waiver I912-FRM-OMBReview-04152016.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Fee Waiver	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 103

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			I912-INS-OMBReview-04152016.pdf	Yes	No	Printable Only
Form	I-912	Request for Fee Waiver	I912-FRM-OMBReview-04152016.pdf	Yes	No	Fillable Printable
Other-Poverty Guidelines			i-912p.pdf	Yes	No	Printable Only

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: USCIS Benefits Information System	FR Citation: 73 FR 56596

Number of Respondents: 502,216	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	502,216	102,216	400,000
Annual IC Time Burden (Hours)	587,593	119,593	468,000
Annual IC Cost Burden (Dollars)	1,883,310	1,883,310	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.