Information Collection

Applicants With a Class A Tuberculosis Condition (As Defined by HHS Regulations)

IC 214079 under ICR 202012-1615-002 · OMB 1615-0032.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0032 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
I690-Sup1-FRM-OMBApproved-07232020.pdf	Other-Supplement

IC Title:

Applicants With a Class A Tuberculosis Condition (As Defined by HHS Regulations)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 8 CFR 245a (To search for a specific CFR, visit the Code of Federal Regulations.)

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
Other-Supplement			I690-Sup1-FRM-OMBApproved-07232020.pdf		Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title: Benefits Information System

FR Citation: 81 FR 72069

Number of Respondents: 11

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	11	11
Annual IC Time Burden (Hours)	22	22
Annual IC Cost Burden (Dollars)	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.