Routine Repatriation Reimbursement Request

U.S. Repatriation Program Forms

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0474 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Routine Repatriation Reimbursement Request Form and Instruction
1 Routine Repatriation Reimbursement Request RR-04 Routine Repatriation Reimbursement Request (1).docx Form and Instruction
1 Routine Repatriation Reimbursement Request RR-04 Routine Repatriation Reimbursement Request (1).docx Form and Instruction

Information Collection (IC) Details

IC Title:	Routine Repatriation Reimbursement Request	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Routine Repatriation Reimbursement Request	RR-04 Routine Repatriation Reimbursement Request (1).docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	250	235	15
Annual IC Time Burden (Hours)	75	70	5
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.