Information Collection

Office of Refugee Resettlement Waiver Request Form

IC 248146 under ICR 202304-0970-006 · OMB 0970-0558.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0558 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Waiver Request Form__06252021.docx	Other-Request Form
Waiver Request Form__06252021.docx	Other-Request Form
Monitoring Generic_0970-0558 - ORR Waiver Request FINAL 06.30.21.docx GenIC Generic Monitoring Activities Submission Form - ORR Waiver Request Form	IC Document
Monitoring Generic_0970-0558 - ORR Waiver Request FINAL 06.30.21.docx GenIC Generic Monitoring Activities Submission Form - ORR Waiver Request Form	IC Document
ORR Waiver Request Procedures__06252021.docx ORR Waiver Request Procedures	IC Document
ORR Waiver Request Procedures__06252021.docx ORR Waiver Request Procedures	IC Document

IC Title:

Office of Refugee Resettlement Waiver Request Form

Agency IC Tracking Number:

ORR

IC Status: Unchanged

Obligation to Respond: Mandatory

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
Other-Request Form			Waiver Request Form__06252021.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 235

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	470	470
Annual IC Time Burden (Hours)	141	141
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
GenIC Generic Monitoring Activities Submission Form - ORR Waiver Request Form	Monitoring Generic_0970-0558 - ORR Waiver Request FINAL 06.30.21.docx	07/01/2021
ORR Waiver Request Procedures	ORR Waiver Request Procedures__06252021.docx	07/01/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.