Application for Civil Surgeon Designation Registration

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0114 can be found here:

Documents and Forms

Document Name Document Type
Designated Civil Surgeons IC.doc Other-Web Announcement

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Civil Surgeon Designation Registration	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 212

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Web Announcement			Designated Civil Surgeons IC.doc		No		Printable Only

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: United States Citizenship and Immigration Services Benefits Information System	FR Citation: 73 FR 56596

Number of Respondents: 1,200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,200	1,200
Annual IC Time Burden (Hours)	1,200	1,200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.