Information Collection Request

Medical Certification for Disability Exceptions

ICR 201909-1615-003 · OMB 1615-0060 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Form N-648 Medical Certification for Disability Exceptions Form Modified Available
N-648 Supporting Statement.docx Supporting Statement A Uploaded 2019-12-04 Available
DHS USCIS PIA 056 20160517.pdf Supplementary Document Uploaded 2019-10-08 Available
DHS USCIS PIA 015 20080905.pdf Supplementary Document Uploaded 2019-10-08 Available
DHS USCIS PIA 003 20070105.pdf Supplementary Document Uploaded 2019-10-08 Available
DHS USCIS ICE CBP 001 SORN 20170918.pdf Supplementary Document Uploaded 2019-10-08 Available
DHS USCIS 007 SORN 20161019.pdf Supplementary Document Uploaded 2019-10-08 Available
N648-INS-TOC-REV-OMBReview-10042019.docx Supplementary Document Uploaded 2019-10-08 Available
N648-FRM-TOC-REV-OMBReview-10042019.docx Supplementary Document Uploaded 2019-10-08 Available
N-648 30 Day FRN.pdf Supplementary Document Uploaded 2019-09-11 Available
N-648 60 Day FRN.pdf Supplementary Document Uploaded 2019-09-11 Available
Reference citation 8-8-12.doc Supplementary Document Uploaded 2012-08-08 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
20362 Medical Certification for Disability Exceptions Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
12/31/2021 36 Months From Approved 05/31/2021
4,138 0 4,138
10,014 0 8,276
213,107 0 202,762





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Medical Certification for Disability Exceptions Form N-648 Medical Certification for Disability Exceptions

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 4,138 4,138 0 0 0 0
Annual Time Burden (Hours) 10,014 8,276 0 1,738 0 0
Annual Cost Burden (Dollars) 213,107 202,762 0 0 10,345 0


Reginfo record details
  No