Report of Medical Examination and Vaccination Record

Report of Medical Examination and Vaccination Record

OMB: 1615-0033

IC ID: 20305

Information Collection (IC) Details

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Report of Medical Examination and Vaccination Record I-693
 
No Modified
 
Required to Obtain or Retain Benefits
 
8 CFR 210 8 CFR 245 8 CFR 209 8 CFR 245a  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form I-693 Report of Medical Examination and Vaccination Record I693-FRM-WIP-LimitedRev-30Day-02042019.pdf www.uscis.gov/i-693 Yes No Fillable Printable
Instruction I693-INS-WIP-LimitedRev-30Day-01312019.pdf www.uscis.gov/i-693 Yes No Printable Only

Homeland Security Border and Transportation Security

USCIS Benefits Information System   81 FR 72069

667,000 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 667,000 0 0 93,000 0 574,000
Annual IC Time Burden (Hours) 1,667,500 0 0 232,500 0 1,435,000
Annual IC Cost Burden (Dollars) 329,331,250 0 0 45,918,750 0 283,412,500

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

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