Information Collection

Verification Request Supplement

IC 214228 under ICR 202010-1615-006 · OMB 1615-0101.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form G-845 Supplement Verification Request Supplement	Form
Form G-845 Supplement Verification Request Supplement Verification Request Supplement	Form
g-845supinstr.pdf	Instruction
g-845supinstr.pdf	Instruction
G-845 Supplement Verification Request Supplement g-845sup.pdf	Form
G-845 Supplement Verification Request Supplement g-845sup.pdf	Form

IC Title:

Verification Request Supplement

Agency IC Tracking Number:

G-845 Supplement

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	G-845 Supplement	Verification Request Supplement	g-845sup.pdf		Yes	No	Fillable Printable
Instruction			g-845supinstr.pdf		Yes	No	Printable Only

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: 44

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	44	-7,078	7,122
Annual IC Time Burden (Hours)	4	-587	591
Annual IC Cost Burden (Dollars)	55	55	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.