OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Report of Medical Examination and Vaccination Record

OMB 1615-0033 ยท DHS/USCIS.

OMB 1615-0033

The information on the application will be used by USCIS in considering eligibility for adjustment of status under 8 CFR part 209, 8 CFR 210.5, 245.5 and 245a.3.

The latest form for Report of Medical Examination and Vaccination Record expires 2027-09-30 and is listed under ICR 202502-1615-001.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form I-693 Report of Medical Examination and Vaccination RecordForm
Form I-693 Report of Medical Examination and Vaccination RecordForm
I-693-016 EXT Supporting Statement 20250204.docxSupporting Statement A
I-693-016 EXT 30-day FRN 90FR42 20250305.pdfSupplementary Document
I-693-016 EXT 30-day FRN 90FR42 20250305.pdf Supplementary Document
I-693-016 Public Comment Response Matrix.docx (document unavailable)Public Comments
I-693 60-Day FRN.pdfSupplementary Document
SORN 007 Benefits Info Sys 2016 10 19.pdfSupplementary Document
SORN 007 Benefits Info Sys 2016 10 19.pdf Supplementary Document
SORN 001 AFileIndexNFTS 2017 09 18.pdfSupplementary Document
privacy-pia-uscis-067-civilsurgeon-june1,2017.pdfSupplementary Document
privacy-pia-003-uscis-iddmp-sept24,2013.pdfSupplementary Document
Reference citations.docSupplementary Document
Report of Medical Examination and Vaccination Record Form
Report of Medical Examination and Vaccination Record Form
Report of Medical Examination and Vaccination Record Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202502-1615-001 Extension without change of a currently approved collection 2025-03-20
202209-1615-003 Revision of a currently approved collection 2022-12-27 Approved without change
202201-1615-003 Extension without change of a currently approved collection 2022-02-18 Approved without change
202108-1615-004 Revision of a currently approved collection 2021-09-08 Approved with change
201901-1615-011 Revision of a currently approved collection 2019-02-08 Approved without change
201710-1615-001 No material or nonsubstantive change to a currently approved collection 2017-10-04 Approved without change
201703-1615-004 No material or nonsubstantive change to a currently approved collection 2017-04-28 Approved without change
201609-1615-004 Revision of a currently approved collection 2016-09-29 Approved with change
201412-1615-012 Revision of a currently approved collection 2015-01-28 Approved with change
201209-1615-001 Revision of a currently approved collection 2012-10-31 Approved with change
201107-1615-005 Revision of a currently approved collection 2011-07-26 Approved with change
201006-1615-005 No material or nonsubstantive change to a currently approved collection 2010-06-16 Approved without change
200912-1615-001 No material or nonsubstantive change to a currently approved collection 2009-12-29 Approved without change
200907-1615-004 Revision of a currently approved collection 2009-07-21 Approved with change
200803-1615-002 No material or nonsubstantive change to a currently approved collection 2008-03-26 Approved without change
200710-1615-001 No material or nonsubstantive change to a currently approved collection 2007-10-09 Approved without change
200703-1615-007 Revision of a currently approved collection 2007-05-24 Approved without change
200603-1615-002 Extension without change of a currently approved collection 2006-03-13 Approved without change
200506-1615-006 Reinstatement without change of a previously approved collection 2005-06-23 Approved without change
200504-1615-002 Extension without change of a currently approved collection 2005-04-29 Improperly submitted and continue
200303-1615-035 Extension without change of a currently approved collection 2003-03-01 Approved without change