Form I-901 Fee Remittance Form - Web Screen Shots

Fee Remittance Form for Certain F, J and M Nonimmigrants

I-901 Screen Shot

Fee Remittance Form for Certain F, J and M Nonimmigrants

OMB: 1653-0034

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1653-0034 can be found here:

2020-03-02 - Revision of a currently approved collection

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Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
202-343-1717, pia@hq.dhs.gov
www.dhs.gov/privacy

Privacy Threshold Analysis – IC/Form

Page 18 of 22

Version number: 04-2016

Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
202-343-1717, pia@hq.dhs.gov
www.dhs.gov/privacy

Privacy Threshold Analysis – IC/Form

Page 19 of 22

Version number: 04-2016

Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
202-343-1717, pia@hq.dhs.gov
www.dhs.gov/privacy

Privacy Threshold Analysis – IC/Form

Page 20 of 22

Version number: 04-2016

Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
202-343-1717, pia@hq.dhs.gov
www.dhs.gov/privacy

Privacy Threshold Analysis – IC/Form

Page 21 of 22

Version number: 04-2016

Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
202-343-1717, pia@hq.dhs.gov
www.dhs.gov/privacy

Privacy Threshold Analysis – IC/Form

Page 22 of 22

Version number: 04-2016

File Type	application/pdf
File Title	Information Collection-Forms PTA
Author	marilyn.powell
File Modified	2018-04-26
File Created	2018-04-26