Information Collection

Marriage & Dissolution Applications, 25 CFR 11.600(c) and 11.606(c)

IC 11464 under ICR 202405-1076-006 · OMB 1076-0094.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Marriage & Dissolution Applications, 25 CFR 11.600(c) and 11.606(c)	Form and Instruction
Application for Dissolution of Marriage APPLICATION DISSOLUTION MARRIAGE_1076-0094.docx www.bia.gov/policy-forms/online-forms/paperwork-reduction-act	Form and Instruction
Marriage License Application MARRIAGE LICENSE APPLICATION_1076-0094.docx www.bia.gov/policy-forms/online-forms/paperwork-reduction-act	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 25 CFR 11.606(c) 25 CFR 11.600(c)

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	N/A	Application for Dissolution of Marriage	APPLICATION DISSOLUTION MARRIAGE_1076-0094.docx	https://www.bia.gov/policy-forms/online-forms/paperwork-reduction-act	Yes	No	Fillable Printable
Form and Instruction	N/A	Marriage License Application	MARRIAGE LICENSE APPLICATION_1076-0094.docx	https://www.bia.gov/policy-forms/online-forms/paperwork-reduction-act	Yes	No	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 260

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	Previously Approved
Annual Number of Responses for this IC	260	260
Annual IC Time Burden (Hours)	65	65
Annual IC Cost Burden (Dollars)	6,500	6,500

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.