Information Collection

Information Relating to Beneficiary of Private Bill

IC 21013 under ICR 202202-1653-005 · OMB 1653-0026.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form G-79A Information Relating to Beneficiary of Private Bill	Form and Instruction
G-79A Information Related to Beneficiary of Private Bill Form G-79A.pdf www.ice.gov/forms	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 8 CFR 212

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 and Instruction	G-79A	Information Related to Beneficiary of Private Bill	Form G-79A.pdf	https://www.ice.gov/forms	Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 35

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	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	35	35
Annual IC Time Burden (Hours)	53	53
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.