Information Collection

EAA Intake Form

IC 266372 under ICR 202403-0970-018 · OMB 0970-0631.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument - Immigration Legal Services for Afghan Arrivals - Eligible Afghan Arrivals Intake Form_clean.docx	Other-Intake Form
Instrument - Immigration Legal Services for Afghan Arrivals - Eligible Afghan Arrivals Intake Form_clean.docx	Other-Intake Form

IC Title:

EAA Intake 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
Other-Intake Form					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: 2,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	160	160
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.

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