Information Collection

Border Crossing Survey – U.S. Embassy Jerusalem Reporting Form

IC 262118 under ICR 202309-1405-002 · OMB 1405-0260.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0260 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Border Crossing Survey – U.S. Embassy Jerusalem Reporting Form	Form and Instruction
U.S. Embassy Jerusalem Incident Reporting Form Border Crossing Survey combined document - with Privacy Act Statement.docx	Form and Instruction
U.S. Embassy Jerusalem Incident Reporting Form Border Crossing Survey combined document - with Privacy Act Statement.docx	Form and Instruction

IC Title:

Border Crossing Survey â U.S. Embassy Jerusalem Reporting Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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 and Instruction	NA	U.S. Embassy Jerusalem Incident Reporting Form	Border Crossing Survey combined document - with Privacy Act Statement.docx		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,293

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,293	3,293
Annual IC Time Burden (Hours)	1,098	1,098
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.