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Non-form request for fee waiver (PDFi)
Request for Fee Waiver
OMB: 1615-0116
IC ID: 272682
OMB.report
DHS/USCIS
OMB 1615-0116
ICR 202411-1615-004
IC 272682
( )
Documents and Forms
Document Name
Document Type
I-912-021-83C_PDFIntakeCopyDeck_11262024.pdf
Other-PDFi
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Non-form request for fee waiver (PDFi)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
8 CFR 103.d
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-PDFi
I-912-021-83C_PDFIntakeCopyDeck_11262024.pdf
Yes
Yes
Fillable Fileable Signable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Homeland Security
Subfunction:
Border and Transportation Security
Privacy Act System of Records
Title:
USCIS Benefits information System
FR Citation:
82 FR 72069
Number of Respondents:
930
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
930
0
930
0
0
0
Annual IC Time Burden (Hours)
930
0
930
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
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.
