Information Collection Request
Medical Examination for Immigrant or Refugee Applicant
ICR 202503-1405-005 · OMB 1405-0113 · Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1405-0113 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form DS-3025 Medical Examination for Immigrant or Refugee Applicant |
Form and Instruction | Unchanged | Available |
| Form DS-3025 Medical Examination for Immigrant or Refugee Applicant |
Form and Instruction | Unchanged | Repair queued |
| Form DS-3025 Medical Examination for Immigrant or Refugee Applicant |
Form and Instruction | New | Available |
| Form DS-3025 Medical Examination for Immigrant or Refugee Applicant |
Form and Instruction | New | Repair queued |
| Form DS-2054 Medical Examination for Immigrant or Refugee Applicant |
Form | Unchanged | Available |
| Form DS-2054 Medical Examination for Immigrant or Refugee Applicant |
Form | Unchanged | Repair queued |
 FW COVID 19 Vaccine Update.msg |
Supplementary Document | Uploaded 2025-03-20 | Available |
| FW COVID 19 Vaccine Update.msg |
Supplementary Document | Uploaded 2025-03-20 | Missing upstream |
 DS-3025 nonsub change justification.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2025-03-20 | Repair queued |
| DS-3025 nonsub change justification.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2025-03-20 | Repair queued |
| (004) Tab 3 -- Legal Authorities -- 30 Day Paper Medical.docx |
Supplementary Document | Uploaded 2022-07-21 | Available |
| (004) Tab 3 -- Legal Authorities -- 30 Day Paper Medical.docx |
Supplementary Document | Uploaded 2022-07-21 | Repair queued |
 SIGNED T3837-21 - PRA Emergency Approval for COVID-19 Vaccine.pdf |
Supplementary Document | Uploaded 2021-12-20 | Repair queued |
| SIGNED T3837-21 - PRA Emergency Approval for COVID-19 Vaccine.pdf |
Supplementary Document | Uploaded 2021-12-20 | Repair queued |
| Justification for Emergency Approval.docx |
Supplementary Document | Uploaded 2021-12-20 | Repair queued |
| Justification for Emergency Approval.docx |
Supplementary Document | Uploaded 2021-12-20 | Repair queued |
| Legal Authorities.docx |
Supplementary Document | Uploaded 2021-12-20 | Repair queued |
| Legal Authorities.docx |
Supplementary Document | Uploaded 2021-12-20 | Repair queued |
| (003) Tab 2 -- Supporting Statement -- 30 Day Paper Medical .docx |
Supporting Statement A | Uploaded 2022-07-21 | Available |
| (003) Tab 2 -- Supporting Statement -- 30 Day Paper Medical .docx |
Supporting Statement A | Uploaded 2022-07-21 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 38745 |  Medical Examination for Immigrant or Refugee Applicant |
Form and Instruction | Unchanged | |
| 38745 | Medical Examination for Immigrant or Refugee Applicant |
Form and Instruction | Unchanged | |
| 274498 | Medical Examination for Immigrant or Refugee Applicant |
Form and Instruction | New | |
| 274498 | Medical Examination for Immigrant or Refugee Applicant |
Form and Instruction | New | |
| 254779 | Medical Examination for Immigrant or Refugee Applicant |
Form | Unchanged | |
| 254779 | Medical Examination for Immigrant or Refugee Applicant |
Form | Unchanged |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | STATE/AFA |
| OMB Control No | 1405-0113 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202207-1405-004 |
| Date Submitted to OIRA | 2025-03-20 |
| Requested Expiration Date | 1969-12-31 |