Information Collection

Fee Waiver Request

IC 12674 under ICR 201711-1125-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Fee Waiver Request	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 8 CFR 1003.8

Information Collection 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 %

	Approved	Previously Approved
Annual Number of Responses for this IC	8,614	8,614
Annual IC Time Burden (Hours)	8,614	8,614
Annual IC Cost Burden (Dollars)	86,140	86,140

Documents for IC

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.