Application for Family Unity Benefits

Application for Benefits Under the Family Unity Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0005 can be found here:

Documents and Forms

Document Name Document Type
Form I-817 Application for Family Unity Benefits Form
I817-011-INS-LimitedREV-60Day-03092023.pdf www.uscis.gov/i-817 Instruction
I817-011-INS-LimitedREV-60Day-03092023.pdf www.uscis.gov/i-817 Instruction
I-817 Application for Family Unity Benefits I817-011-FRM-LimitedREV-60Day-03132023.pdf www.uscis.gov/i-817 Form
I-817 Application for Family Unity Benefits I817-011-FRM-LimitedREV-60Day-03132023.pdf www.uscis.gov/i-817 Form

Information Collection (IC) Details

IC Title:	Application for Family Unity Benefits	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 8 CFR 210

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	I-817	Application for Family Unity Benefits	I817-011-FRM-LimitedREV-60Day-03132023.pdf	https://www.uscis.gov/i-817	Yes	No	Fillable Printable
Instruction			I817-011-INS-LimitedREV-60Day-03092023.pdf	https://www.uscis.gov/i-817	Yes	No	Printable Only

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: USCIS Benefits Information System	FR Citation: 73 FR 56596

Number of Respondents: 346	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	346	-654	1,000
Annual IC Time Burden (Hours)	657	-1,343	2,000
Annual IC Cost Burden (Dollars)	42,385	-80,115	122,500

Documents for IC

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.