Information Collection

Non-form request for fee waiver (PDFi)

IC 272682 under ICR 202411-1615-004 · OMB 1615-0116.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0116 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
I-912-021-83C_PDFIntakeCopyDeck_11262024.pdf	Other-PDFi
I-912-021-83C_PDFIntakeCopyDeck_11262024.pdf	Other-PDFi

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:

table that charts list of 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

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 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	930	930
Annual IC Time Burden (Hours)	930	930
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.