Information Collection

Application for Replacement/Initial Nonimmigrant Arrival-Departure Document

IC 20403 under ICR 201708-1615-002 · OMB 1615-0079.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0079 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form I-102 Application for Replacement/Initial Nonimmigrant Arrival-Departure Document	Form
I102-INS-30 Day-07242017.pdf www.uscis.gov/i-102	Instruction
I-102 Application for Replacement/Initial Nonimmigrant Arrival I102-FRM-30 Day-07242017.pdf www.uscis.gov/i-102	Form

IC Title:

Application for Replacement/Initial Nonimmigrant Arrival-Departure Document

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 8 CFR 264

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	I-102	Application for Replacement/Initial Nonimmigrant Arrival-Departure Doucment	I102-FRM-30 Day-07242017.pdf	www.uscis.gov/i-102	Yes	No	Fillable Printable
Instruction			I102-INS-30 Day-07242017.pdf	www.uscis.gov/i-102	Yes	No	Printable Only

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: U.S. Citizenship and Immigration Services Benefits Information System

FR Citation: 81 FR 72069

Number of Respondents: 6,899

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	6,899	2,912	3,987
Annual IC Time Burden (Hours)	5,174	2,184	2,990
Annual IC Cost Burden (Dollars)	1,892,870	798,837	1,094,033

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.