Information Collection

CIS OMBudsman Case Assistance Form

IC 44790 under ICR 201807-1601-001 · OMB 1601-0004.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1601-0004 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DHS Form 7001 Citizenship and Immigration Services Ombudsman CIS Ombudsman Case Assistance Form	Form
Form DHS Form 7001 Citizenship and Immigration Services Ombudsman CIS Ombudsman Case Assistance Form	Form
cisomb_dhsform7001_instructions_AUG_2014_V24.pdf	Instruction
DHS Form 7001 Citizenship and Immigration Services Ombudsman OMBUDSMAN DHS Form 7001_FINAL.pdf	Form
DHS Form 7001 Citizenship and Immigration Services Ombudsman 1601-0004 (DHS Form 7001) OCA 2015 company screenshots.pdf	Form

IC Title:

CIS Ombudsman Case Assistance Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction		Yes	No	Fillable Printable
Form	DHS Form 7001	Yes	No	Fillable Printable
Form	DHS Form 7001	Yes	Yes	Fillable Fileable Signable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 12,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	12,000	3,200	8,800
Annual IC Time Burden (Hours)	12,000	3,200	8,800
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.

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