Verification Request

Verification Request and Verification Request Supplement

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0101 can be found here:

Documents and Forms

Document Name Document Type
Form G-845 Verification Request Form
g-845instr.pdf Instruction
g-845instr.pdf Instruction
G-845 Verification Request g-845.pdf Form
G-845 Verification Request g-845.pdf Form

Information Collection (IC) Details

IC Title:	Verification Request	Agency IC Tracking Number:	G-845

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	G-845	Verification Request	g-845.pdf		Yes	No	Fillable Printable
Instruction			g-845instr.pdf		Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: SAVE Program SORN	FR Citation: 77 FR 47415

Number of Respondents: 7	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	7	-162,099	162,106
Annual IC Time Burden (Hours)	1	-13,454	13,455
Annual IC Cost Burden (Dollars)	9	-204,245	204,254

Documents for IC

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.